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J Reconstr Microsurg 2014; 30(09): 589-598
DOI: 10.1055/s-0034-1381955
Invited Review
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Role of Platelet Inhibition in Microvascular Surgery

Eugenia H. Cho
1   Division of Plastic and Reconstructive Surgery, Duke University Health System, Durham, North Carolina
,
Cassandra Ligh
1   Division of Plastic and Reconstructive Surgery, Duke University Health System, Durham, North Carolina
,
Kimberly L. Hodulik
2   Division of Hematology, Duke University Health System, Durham, North Carolina
,
Scott T. Hollenbeck
1   Division of Plastic and Reconstructive Surgery, Duke University Health System, Durham, North Carolina
› Author Affiliations
Further Information

Publication History

10 February 2014

30 March 2014

Publication Date:
04 August 2014 (online)

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Abstract

Thrombosis remains a significant complication of microvascular free tissue transfer. Recent discoveries in the field of vascular biology have led to a greater understanding of thrombogenesis and the pivotal role that platelets play in the formation of a clot. However, current antithrombotic strategies in the clinical practice of free tissue transfer have not typically focused on platelet inhibition. Decades of cardiovascular clinical trials have delineated the essential role of platelet inhibitor therapy in patients with acute coronary syndromes and those undergoing percutaneous coronary interventions. Understanding the current treatment guidelines for antiplatelet therapy across the spectrum of patients with coronary heart disease may provide insights into their use in the prevention and treatment of thrombosis in microvascular surgery. In this review, we examine the current antiplatelet agents in clinical use and discuss the potential role of platelet inhibition in free flap surgery, particularly in the setting of repeated microvascular thrombosis.

Keywords

platelet inhibition - flap surgery - thrombosis - microvascular
 

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