Effects of ticagrelor on the thrombosis creating in rat's femoral artery tuck procedure

ABSTRACT EFFECTS OF TICAGRELOR ON THE THROMBOSIS CREATING IN RAT'S FEMORAL ARTERY TUCK PROCEDURE A huge improvement at microsurgery has happened nowadays via advanced microscopes and suturing technology. But thrombus formation, due to sutures during anastomosis or blunt traumas to vessels, is still most common seen complication. These trombi prevent blood flow to distal area of anastomosis and cause failure of operation. Administration of anticoagulant therapy to microsurgery patients had been started after discovery of Heparin. Ticagrelor, which is an antithrombocyte agent, affects as adenosine diphosphate (ADP) receptor antagonist that prevents ADP dependent thrombocyte activation and aggregation. It was thought that Ticagrelor may reduce thrombus risk at vascular microsurgery and a study was planned to prove that. 'Tuck' procedure performed at rats' femoral arteries for creating thrombus. In this study, total 40 Wistar albino rats were used, 20 of them were for control group and 20 of them were for experimental group. Procedures were performed on both of the femoral arteries of subjects. Five rats from control group and 5 rats from experimental group were excluded from study due to vascular damage or death of rats. Total 60 femoral arteries, 30 for each group, were examined. In operation after dissecting femoral artery, bulldog clamps were put both at proximal and distal ends. 180 degree-arteriotomy which includes 50% of lumen was performed horizontally to femoral artery. 2-3 sutures were put to fold distal segment into femoral artery. Distal wall of femoral artery were inverted to lumen by these sutures and femoral artery was introverted. In this way, a valve was created against blood flow in artery lumen and thrombus formation possibility in this area was increased. Oral ticagrelor 2x10 mg/kg had been administered to rats at experimental group, in the period of preoperative 24 hours and postoperative 14 days. At the end of the study, flow presence was observed at milking test at 20 rats (66,7%) in ticagrelor group and at 8 rats (26,7%) in control group. Histopathologic investigations showed that thrombus were present at 8 rats (26,7%) in experimental group and at 20 rats (66,7%) in control group. Edema was present on vascular wall at 6 rats (20%) in ticagrelor group and at 19 rats (66,3%) in control group. Inflammation was present at 5 rats (16,7%) in ticagrelor group and at 17 rats (56,7%) at control group. Endothelialisation was found at 18 rats (60%) in ticagrelor group and at 13 rats (43,3%) in control group. There isn't statistically significant difference between endothelialisation percents. But statistically significant differences on behalf of ticagrelor were found at milking test, thrombus formation, edema and inflammation. We concluded that ticagrelor can prevent thrombus formation at microsurgery operations and it can also be used at the presence of thrombus creating factors. Key words: anticoagulant theraphy at microsurgery, thrombus, ticagrelor, rat 'tuck' model.