After this operative procedure is performed how come the 'new' arterial surface doesn't form thrombi (or does it)? Shouldn't the exposed non-endothelial surface be highly thromogenic?
I link some studies concerning survival and long term outcomes which clearly prove the benefits od intervention and prove that thrombi formation isn't a rule, but which is in disagreement with the standard thaught mechanism of vascular thrombi formation (exposed subendothelium being highly thrombogenic).
Looking forward to hear some answers, thoughts and ideas from experienced people.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3561447/
http://www.ncbi.nlm.nih.gov/pubmed/10753280
You remove the media level together with the atherosclerotic plaque. After a good, clear, non-atheromatous thromboendarterectomy, the surface is devoid of plaques and quite clean. Also, during and after the procedure heparin is administered.
I always close the arteriotomy with a patch. If your hypothesis would be true, then everybody should also concern about thrombosis at the patch side.
Just perform an uneventful operation, leave a clean surface, close with a patch, give heparin after the procedure for 24-48 hours and continue with aspirin and clopidogrel, give statins; and don't worry about thrombus formation or re-stenosis.
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