Intravascular coagulation is the final common pathway of failure in replanted digits and 'free' tissue transfers. To address this clinical problem, a model based upon intimal damage and stasis in the rat femoral vein was developed. The ability of local, intraarterially administered thrombolysin to achieve 'local' clot lysis was investigated. 'Systemic anticoagulation' was measured by standard hematologic monitoring and 'systemic thrombolysis' by lysis of a contralateral standard femoral vein clot. The mean drug volume required for local clot lysis was proportional to the clots' duration time; 7.8 ml required for the 30-min, and 17.0 ml required for the 60-min clot (p <0.05). Lysis was achieved by local intraarterial thrombolysin in 87% of the clots of 30-min duration and in 94% of the clots of 60-min duration. Overall, just 3.6% of contralateral clots lysed (p <0.001). Systemic anticoagulation did not occur.
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