Abstract Number: PB0152
Meeting: ISTH 2020 Congress
Background: Tourniquets are commonly used to control intraoperative blood loss in major orthopedic surgeries, such as total knee arthroplasty (TKA). Despite the widespread use, the research evaluating the risk of developing postoperative complications and effectiveness of intraoperative tourniquet use remains inconclusive. With a symptomatic incidence of ~10%, thromboembolic events are a major postoperative complication for TKA patients and can result in associated morbidity and mortality1.
Aims: To evaluate the association between tourniquet application and early indicators of thromboembolic events in a rat model.
Methods: Male Sprague Dawley rats weighing ~325g were anesthetized under isoflurane. For experimental animals, a tourniquet standardized to 38 newtons was applied for 3-hours around the hind-leg, at the proximal region of the femur. Control animals did not receive tourniquet application. All subjects were placed on a heating pad, had vitals regularly monitored and placed in a supine position. After 3 hours, the tourniquet was removed on experimental animals and blood was collected from the tail vein of all subjects. Plasma D-Dimer was measured using Asserachrom D-Di (Diagnostic Stago), an enzyme immunoassay of D-Dimer by ELISA method.
Results: Four experimental and four control animals were included in the study. The experimental animals demonstrated significantly elevated levels of plasma D-Dimer. The mean plasma D-Dimer values for experimental and control animals was 289.3 ng/mL and 67.37 ng/mL, respectively (P=0.0035). Three hour tourniquet application caused visible tissue damage in the vasculature and musculature of the rat’s hind limb (Figure 1).
Conclusions: The results suggest greater blood clot formation and an increased risk for venous thromboembolism in animals with tourniquet application. This animal model highlights the potential thromboembolic risks and complications associated with tourniquet application in major orthopedic surgeries. Further research is required to identify thromboembolic events in rats, such as deep vein thrombosis and pulmonary embolism.
To cite this abstract in AMA style:Chung J, Mian O, Chan A, Matino D. Early Indicators of Thromboembolic Events Caused by Prolonged Tourniquet Application: A Rat Model [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/early-indicators-of-thromboembolic-events-caused-by-prolonged-tourniquet-application-a-rat-model/. Accessed May 6, 2021.
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