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2013 | 85 | 11 | 638-643
Tytuł artykułu

The changes of plasma thrombin-antithrombin complex in the patients with peripheral arterial disease undergoing surgical revascularization

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
In patients with severe lower limb ischemia the coagulation and fibrinolytic systems have been found to be activated preoperatively. The aim of the study was to evaluate the changes of TAT level as a selected coagulation factor, before, during and after surgical revascularization and the analysis of the impact of coexisting diseases on the coagulation during the procedure. Material and methods. 50 patients with PAOD, in Fontaine stages IIb to IV (29 men and 21 women; median age 65.8 years, ASA II/III) undergoing elective surgical revascularization were studied. Two groups of patients were compared: 20 undergoing reconstruction on aorto-femoral and 30 on femoropopliteal level. Blood samples were collected 5 times: 24 hours before the operation; intraoperatively after artery exposure; after heparin administration and clamping; after reperfusion and -24 hours postoperatively. Results. Elevated values of TAT (10.5 g/l ±7.1) were found before the operation. The elevated value of TAT increased intraoperatively (25.1 g/l ±44.58; p<0.001) (norm 1-4.1 g/l) and maintaining higher levels after the surgery. The significant correlations between plasma level of TAT and ischemia degree were found. Also the correlation between intraoperative increase of TAT and the duration of surgery was noticed. No significant differences between two analysed groups were observed. Conclusions. The results indicate the activation of coagulation and prothrombotic state in the patients with advanced arteriosclerosis. During the surgical revascularisation permanent increase of activation of blood coagulation was observed. This activation depends on duration of the procedure and maintains increased one-day after the operation. Our findings may explain the unexpected occurrence of early thrombotic complications after technically successful vascular reconstructions.
Wydawca

Rocznik
Tom
85
Numer
11
Strony
638-643
Opis fizyczny
Daty
wydano
2013-11-01
online
2013-12-31
Twórcy
  • Department of Vascular Surgery and Angiology, Medical University in Lublin
  • Department of Vascular Surgery and Angiology, Medical University in Lublin
autor
  • Department of Vascular Surgery and Angiology, Medical University in Lublin
  • Department of Vascular Surgery and Angiology, Medical University in Lublin
  • Department of Vascular Surgery and Angiology, Medical University in Lublin
Bibliografia
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  • 2. Parsson H, Holmberg A, Siegbahn A et al.: Activation of coagulation and fibrinolytic systems in patients with CLI is not normalized after surgical revascularisation. Eur J Vasc Endovasc Surg 2004; 27(2): 186-92.[PubMed][Crossref]
  • 3. Cassar K, Bachoo P, Ford I et al.: Markers of coagulation activation, endothelial stimulation and inflammation in patients with peripheral arterial disease. Eur J Vasc Endovasc Surg 2005; 29(2): 171-76.[Crossref][PubMed]
  • 4. Strano A, Hoppensteadt D, Walenga JM et al.: Plasma levels of the molecular markers of coagulation and fibrinolysis in patients with peripheral arterial disease. Semin Thromb Hemost 1996; 22 Suppl 1: 35-40.[PubMed]
  • 5. W roński J: Zaburzenia krzepnięcia w chorobie Buergera. Praca doktorska. Akademia Medyczna w Lublinie, Lublin 1997.
  • 6. Peltonen S, Lassila R, Rossi P et al.: Blood coagulation and fibrinolysis activation during sudden arterial occlusion of lower extremities - an association with ischemia and patient outcome. Thromb Haemost 1995; 74(6): 1442-46.[PubMed]
  • 7. Giannitsis E, Siemens HJ , Mitusch R et al.: Prothrombin fragments F1+2, thrombinantithrombin III complexes, fibrin monomers and fibrinogen in patients with coronary atherosclerosis. Int J Cardiol 1999; 68(3): 269-74.
  • 8. U ndas A, Stepień E, Branicka A et al.: Thrombin formation and platelet activation at the site of vascular injury in patients with coronary artery disease treated with clopidogrel combined with aspirin. Kardiol Pol.2009; 67(6): 591-98.
  • 9. Figueras J, Monasterio Y, Lidon RM et al.: Thrombin formation and fibrinolytic activity in patients with acute myocardial infarction or unstable angina: in-hospital course and relationship with recurrent angina at rest. J Am Coll Cardiol 2000; 36(7): 2036-43.[PubMed][Crossref]
  • 10. Cugno M, Mari D, Meroni PL et al.: Haemostatic and inflammatory biomarkers in advanced chronic heart failure: role of oral anticoagulants and successful heart transplantation. Br J Haematol 2004; 126(1): 85-92.[Crossref]
  • 11. Soroka-Wojtaszko M, Dmoszyńska A, Słoma- Madej K i wsp.: Markery aktywacji wczesnej fazy krzepnięcia i fibrynolizy u chorych z zawałem mózgu w najwcześniejszym okresie choroby. Pol Arch Med Wewn 2004; 112(5): 1303-09.
  • 12. Haapaniemi E, Soinne L, Syrjala M et al.: Serial changes in fibrinolysis and coagulation activation markers in acute and convalescent phase of ischemic stroke. Acta Neurol Scand 2004; 110(4): 242-47.[PubMed][Crossref]
  • 13. Meng R, Li ZY , Ji X et al.: Antithrombin III associated with fibrinogen predicts the risk of cerebral ischemic stroke. Clin Neurol Neurosurg 2011; 113(5): 380-86.[PubMed][Crossref][WoS]
  • 14. Tschopl M, Tsakiris DA , Marbet GA et al.: Role of hemostatic risk factors for restenosis in peripheral arterial occlusive disease after transluminal angioplasty. Arterioscler Thromb Vasc Biol 1997; 17(11): 3208-14.[PubMed][Crossref]
  • 15. Cassar K, Bachoo P, Ford I et al.: Clopidogrel has no effect on D-dimer and thrombin-antithrombin III levels in patients with peripheral arterial disease undergoing peripheral percutaneous transluminal angioplasty. J Vasc Surg 2005; 42(2): 252-58.[Crossref]
  • 16. Englberger L, Savolainen H, Jandusa P et al.: Activated coagulation during open and endovascular abdominal aortic aneurysm repair. J Vasc Surg 2006; 43(6): 1124-29.[Crossref][PubMed][WoS]
  • 17. Bailey MA, Griffin KJ , Sohrabi S et al.: Plasma thrombin-antithrombin complex, prothrombin fragments 1 and 2, and D-dimer levels are elevated after endovascular but not open repair of infrarenal abdominal aortic aneurysm. J Vasc Surg 2013; (w druku).[WoS]
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Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_pjs-2013-0096
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