Dextran in Vascular Surgery

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Abstract
Dextran is a colloid, composed of chain of glucose molecules. These chains are formed by an enzymatic action of the bacteria leuconostoc mesenteroides on sucrose.1 The molecular weight of these molecules can be several millions, but to be used clinically it should not exceed 100.000. A decrease in the molecular weight can be accomplished by fractionation of the molecules. On the other hand the molecular weight should not be lower than about 40.000, in order to remain in the circulation for a reasonable length of time. Rheomacrodex®, or Dextran 40 has the lowest molecular weight of all dextran fractions used clinically. In this review will be summarized the different indications of the use of dextran, and particularly Dextran 40, in vascular surgery, the rationale behind its use will be dis cussed, and the literature on this subject will be reviewed.