Platelets, prostaglandins, and patency in microvascular surgery

Abstract

In light of recent research dealing with the proaggregatory and antiaggregatory effects of prostaglandins on the primary hemostatic event of platelet aggregation, we suggest that patency in microvascular surgery be viewed from a new perspective. The sequence of events in platelet aggregation and the effects of the products of arachidonic acid metabolism on these events are reviewed. Drugs affecting platelet aggregation are classified according to their sites of action. In particular, heparin, dextran, and aspirin are discussed in relation to new information regarding their effects on arachidonic acid metabolism. Original early experimental work and clinical reports from the literature are discussed with a view toward future directions for research in improving patency in microvascular surgery.