Effect of Heparin and Dicoumarol on Sludge Formation

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Abstract
The effects of heparin and dicoumarol on sludge formation in small vessels following acute main stem venous occlusions were studied. Observations were made on mesenteric vessels, using a Kniseley fused quartz rod transillumination apparatus employing a constant-temp. tissue bath with variable vol. flow. Young dogs were used under nembutal anesthesia. In controls, the portal or superior mesenteric vein was occluded for 1 hr. Sludge formation occurred within 10-20 min. in the small peripheral mesenteric vessels. Thrombus formation occurred in some of the small vessels usually within 30 min. after the appearance of the sludge. By the time of release (1 hr.), the flow had ceased completely or was ebbing. Thrombosis involved the following steps: 1) sludge formation; 2) adherence of sludged masses to blood vessel linings; 3) piling up of more cells to the agglutinated mass; and 4) stoppage of flow. In some dogs 6-10 mg. of heparin were injected into a tongue vein as soon as sludge formation occurred. This did not change the nature of the sludge. However, the clumps did not adhere to the vessel wall as easily as in the controls. On removing the obstruction, the flow was resumed in all such vessels. In other expts., heparin was injected intraven. in doses of 5-10 mg. before occlusion of the main vein. Sludge appeared in 9-35 min. The sludge did not adhere to the endothelial lining. Only 25% of the vessels became involved, the rest being patent. Heparinization thus helps prevent thrombus formation around sludged cells. Six dogs were given dicoumarol in doses from 25-50 mg./day for 3 days. Venous occlusions were done and the small vessels were observed. Sludge appeared in every instance within 10-30 min. The sludge did not adhere to the endothelial lining and broke up easily. There was no thrombus formation.

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