ULTRASTRUCTURAL CHANGES OF THE VESSELS OF THE HAEMOMICROCIRCULATORY BED OF HIND LIMBS OF THE RATS WITH ACUTE ISCHEMIA CAUSED BY ARTERIAL TOURNIQUET APPLICATION
DOI:
https://doi.org/10.11603/1811-2471.2019.v.i4.10812Keywords:
acute ischemia, reperfusion, haemomicrocirculatory bed, electron microscopyAbstract
Arterial tourniquets are widely used in both military and civil medicine (particularly in the case of limb injuries, arthroplasty and angioplasty). Restoring the blood supply to the limb after removal of the tourniquet can cause ischemic-reperfusion lesions of both the primary ischemic tissues and distant tissues and organs. However, the ultrastructural changes of tissues at the local level by ischemia-reperfusion are in need of deeper study today.
The aim of the study – to establish the condition of the haemomicrocirculatory bed of the hind limbs of rats with acute ischemia and subsequent reperfusion caused by the arterial tourniquet application.
Materials and Methods. The electron microscopic examination of the blood vessels of the haemomicrocirculatory bed of the skeletal muscles of the hind limbs of 12 rats under experimental acute ischemia was performed. There were 3 intact animals in the control group. Acute ischemia was caused by application of SWAT rubber bands on the hind limbs of animals, 5–6 mm width, at the inguinal fold level within 2 hours under thiopental anesthesia, and reperfusion was modeled by removing the tourniquet. The examination of muscle tissue samples was carried out at the department of histology and embryology, I. Horbachevsky Ternopil National Medical University by using an electron microscope PEM-125K.
Results and Discussion. Electron microscopy of the skeletal muscles of the hind limbs of rats revealed in the vessels of the haemomicrocirculatory bed destructively altered hemocapillaries with unequal wall thickness, pronounced oedema of endothelial cells with their protrusion into the lumen of the haemocapillaries, desquamation of single endothelial cells, thickening of the basal membrane, enlarged by oedema perivascular spaces, accumulation of lymphocytes in the paravasal space, appearance of protein and erythrocytes extravasation around the haemocapillaries. Often in the lumen of vessels near the endothelial cells platelets were visualized, indicating the development in the haemocapillaries of microthrombosis near its wall. Ultrastructural changes were observed already within two hours after the removal of the tourniquet and were most pronounced after one day. In the late reperfusion period there was a reverse development of pathological changes, however, even after 14 days of ischemia-reperfusion the complete restoration of ultrastructure of haemomicrocirculatory bed still did not happen.
Conclusions. The ultrastructural disorders in vessels of the haemomicrocirculatory bed of ischemic muscular tissue of the hind limbs reached maximal expression in rats one day after the removal of the tourniquet, confirming the development in experimental animals of ischemic-reperfusion syndrome. In the later reperfusion period there was a reverse development of pathological changes.
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