Vein wall re-endothelialization after deep vein thrombosis is improved with low-molecular-weight heparin

A, Thrombus size peaks at day 4 after ligation. Sham operation group is the inferior vena cava (IVC) weight-to-length measure only (n = 5-8). *P < .05. B, Percentage of luminal staining positive for von Willebrand factor (vWF) over time after stasis thrombosis or sham control (n = 3-4).*P < .05. C, Cross-sectional area of α-smooth muscle actin (α-SMA) staining in medial vein wall, corrected for circumference, after stasis thrombosis or sham control (n = 4).*P < .05. DVT, Deep vein thrombosis; VSMC, vascular smooth muscle cells. Error bars signify the standard error.

A, Thrombus size with vehicle treatment prethrombosis and post-thrombosis low molecular weight heparin (LMWH) treatment. No significant difference was observed. B, Thrombus size with vehicle, and prethrombosis and post-thrombosis LMWH treatment. Treatment with LMWH before and after thrombosis was associated with smaller thrombi (n = 6-8). *P < .05. IVC, Inferior vena cava. Error bars signify the standard error.

A, Graphic representation of vehicle (none), and prethrombosis and post-thrombosis low-molecular-weight heparin (LMWH) effect on percentage of positive von Willebrand factor (vWF) luminal staining at 4 days. A significantly greater luminal area was positive for vWF with LMWH treatment (n = 4-7). Error bars signify the standard error. DVT, Deep vein thrombosis. B, Example of sham inferior vena cava stained for vWF to denote the endothelial layer. Brown stain indicates the endothelium (arrows) at ×400 original magnification. C, Vehicle (none) thrombosed inferior vena cava. A large thrombus is seen with luminal staining and a small amount of luminal vWF staining (arrow), at ×400 original magnification. W, Vein wall. D, Prethrombosis LMWH treatment. Note large thrombus (T) but more luminal positive vWF staining (arrows) at ×400 original magnification. W, Vein wall.

A, Graphic representation of vehicle (none), and prethrombosis and post-thrombosis low-molecular-weight heparin (LMWH) treatment on vein wall α-smooth muscle actin (α-SMA) area staining at 4 days (n = 5-8). DVT, Deep vein thrombosis; VSMC, vascular smooth muscle cell. B, Example of sham control vein, showing brown medial area of α-SMA staining (arrows) at ×400 original magnification. W, Vein wall. C, Vehicle (none) treatment example showing thin brown α-SMA area, at 4 days (arrows) at ×400 original magnification. T, Thrombus; W, vein wall. D, Prethrombosis LMWH treatment. Not larger and more diffuse α-SMA area (arrows) at ×400 original magnification. T, Thrombus; W, vein wall.

Interleukin 1β (IL-1β; 1 ng/mL) 48-hour stimulated post-thrombosis vein wall tissue culture. Harvested tissue was at 4 days or 14 days before harvest. A, Inducible nitric oxide synthase (iNOS) 14-day gene expression shows greater expression in the vehicle (none) thrombosed inferior vena cava (IVC) and significantly lesser expression with post-thrombosis low-molecular-weight heparin (LMWH) treatment (n = 5). *P < .05. B, Endothelial nitric oxide synthase (eNOS) 4-day gene expression shows significantly reduced expression with vehicle and thrombosis LMWH treatment compared with sham (n = 4-6). *P < .05. C, Thrombomodulin (TM) 4-day gene expression shows significantly reduced expression with vehicle and post-thrombosis LMWH treatment compared with sham (n = 6) *P < .05. D, Collagen III expression at 14 days shows significantly increased expression with prethrombosis and post-thrombosis LMWH treatment compared with sham (n = 4-5). *P < .05.