Background: The botulinum toxin A potential role in preventing femoral artery post-anastomotic thrombosis lies in its ability to reduce smooth muscle spasm. By inhibiting acetylcholine release, it may decrease vasoconstriction at the anastomosis site, thus improving blood flow. The present work aimed to assess the effect of botulinum toxin type A injection in prevention of post anastomotic thrombosis in femoral arteries in male albino rats.

Methods: We conducted a study with twenty male albino rats, each weighing between 200 and 350 grams. These rats were carefully divided into two groups. In Group A, we precisely administered 10 units of botulinum toxin type A, diluted in a small amount (0.5 cc) of sterile saline solution (0.9% sodium chloride), around the femoral artery in their right leg. This targeted injection was performed within the perivascular space, the area immediately surrounding the artery.

Results: The post-anastomotic diameter of the femoral arteries showed a statistically significant difference (p=0.002) between the groups that were investigated. A statistically significant difference was revealed between diameter of femoral artery before and after microvascular anastomosis in group B (p=0.025). A statistically significant difference was revealed between the studied groups according to the occurrence of thrombosis in anastomosed femoral arteries 1 hour after exposure to ice packs cold challenge (p=0.001).

Conclusion: Botulinum toxin A had a significant role in enhancing vascular outcomes. The findings suggest that BTX-A injections can effectively reduce the incidence of thrombosis by promoting vasodilation and improving blood flow in the femoral arteries.