The basic study of transcatheter intra-arterial thrombolysis in the treatment of severe frostbite

doi:10.3877/cma.j.issn.2095-5782.2022.02.008

Abstract

Abstract:

Objective

To explore the efficacy and mechanism of transcatheter arterial compound Danshen injection infusion in the treatment of severe frostbite in New Zealand white rabbits.

Methods

36 New Zealand white rabbits with severe frostbite underwent routine rewarming and were randomly divided into 3 groups, Group A: conventional thrombolytic group (t-PA + heparin + papaverine), B Group: modified thrombolytic group (t-PA + heparin + papaverine + compound Danshen injection), group C: control group (normal saline). Severe frostbite model of 10 New Zealand white rabbits in each group were assessed by angiographic response 24 hours after thrombolytic therapy. Blood routine, coagulation and fibrinolytic activity indicators, TXB2, 6-keto-PGF1α , MDA, SOD were measured and compared between groups.The remaining 2 rabbits in each group were performed histopathological examination, the final amputation was analyzed by toe amputation rate and scoring method and compared between groups.

Results

Complete response in angiographic assessment in group A, B and C occured in 3, 0, 0 cases, majority response in 4, 2, 0 cases, mild response in 2, 4, 2 cases, no response in 1, 4, 8 cases. There was significant difference in the number of WBCs among all groups after thrombolytic therapy (P < 0.05). There was no significant difference in RBC, HGB and HCT (P > 0.05). The number of platelets in group A and group B was significantly higher than that in group C (P < 0.05). PT and APTT in group A and group B were significantly longer than those in group C (P < 0.05). FIB in group A and group B was significantly lower than that in group C (P < 0.05). The levels of plasma 6-keto-PGF1α and SOD in group B were significantly higher than those in group A and C (P < 0.05). The levels of TXB2 and MDA in group B were significantly lower than those in group A and C (P < 0.05). The toes amputation rates of group A, B and C were 46.9%, 22.5% and 85.0% respectively. The results of scoring method were 9.5 ± 2.7, 4.3 ± 1.1 and 21.8 ± 4.2 respectively. There were significant differences in amputation rate and score among all groups (P < 0.05).

Conclusions

Compound Danshen injection can significantly reduce the rate of toe amputation in severely frostbitten rabbits, the possible mechanism may be that compound Danshen injection can correct the PGI2-TXA2 and oxidation-antioxidation imbalance.

Key words: Frostbite, Intra-arterial infusion, Thrombolysis, Angiography

Jinxin Fu, Feng Duan, Jinlong Zhang, Bing Yuan, Heng Zhang, Jieyu Yan, Yang Guan, Yan Wang, Kai Yuan, Maoqiang Wang. The basic study of transcatheter intra-arterial thrombolysis in the treatment of severe frostbite[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2022, 10(02): 162-168.

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