CROSS-LINKED FIBRIN DEGRADATION PRODUCTS (XL-FDP) AS MARKER OF EARLY RETHROMBOSIS IN PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY

被引：5

作者：

JORGENSEN, B

NIELSEN, JD

NORGARD, J

HELLIGSO, P

BAEKGAARD, N

EGEBLAD, M

机构：

[1] Department of Vascular Surgery Unit, Skejby Hospital, University of Aarhus

[2] Department of Radiology, Skejby Hospital, University of Aarhus

[3] Thrombosis Research Centre, Bispebjerg Hospital, University of Copenhagen

来源：

EUROPEAN JOURNAL OF VASCULAR SURGERY | 1993年 / 7卷 / 06期

关键词：

TRANSLUMINAL ANGIOPLASTY; FEMORAL ARTERY; FIBRIN DEGRADATION PRODUCTS; D-DIMER; DIAGNOSIS; THROMBOSIS; THROMBOLYTIC THERAPY;

D O I：

10.1016/S0950-821X(05)80724-8

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The thrombotic response to percutaneous transluminal angioplasty (PTA) was investigated in 31 patients treated for 1-10cm femoropopliteal (n = 28) and tibial (n = 3) artery obstructions by measurement of cross-linked fibrin degradation products (XLFDP) in peripheral blood samples drawn before and 30 min after PTA. XL-FDP increased from 400 ± 147ng/ml to 700 ± 445 ng/ml (median ± s.e., p = 0.0005). XL-FDP rose from 320 ± 110 ng/ml to 540 ± 102 ng/ml in 23 patients, whose anklel brachial systolic blood pressure index (ABI) increased > 0.15 after PTA, whereas XL-FDP increased from 850 ± 450 ng/ml to 2620 ± 1472 ng/ml in eight patients, who failed to increase ABI in spite of preceding recanalisation. XL-FDP increased by more than 1000 ng/ml in 1/23 (4.3%) patients with uncomplicated PTA and in 6/8 (75%) patients with haemodynamic failure (p = 0.0005). Using a XL-FDP increase of 1000 ng/ml as cut-off, estimates of positive and negative predictive values (95% confidence limits) for early failure of PTA were 85.7% (42.1-99.6%) and 91.7% (73.0-99.0%), respectively. We conclude from this pilot study that femorotibial PTA produces a hypercoagulable state which may result in failure of early patency due to rethrombosis. We suggest for the first time XL-FDP as a marker of early rethrombosis in PTA, and report a sequential XL-FDP assay which may be useful for identification of high-risk patients requiring thrombolytic therapy after PTA for maintenance of early vascular patency. © 1993 Grune & Stratton Ltd.

引用

页码：720 / 724

页数：5

共 24 条

[11] Rylatt, Blake, Cottis, Et al., An immunoassay for human D dimer using monoclonal antibodies, Thrombosis Research, 312, pp. 767-778, (1983)
[12] Boisclair, Ireland, Lane, Assessment of hypercoagulable states by measurement of activation fragments and peptides, Blood Rev, 4, pp. 25-40, (1990)
[13] Nossel, Yudelman, Canfield, Et al., Measurement of fibrinopeptide A in human blood, J Clin Invest, 54, pp. 43-53, (1974)
[14] Eisenberg, Sherman, Rich, Et al., Importance of continued activation of thrombin reflected by fibrinopeptide A to the efficacy of thrombolysis, J Am Coll Cardiol, 7, pp. 1255-1262, (1986)
[15] Blattler, Cappius, Haeberli, Foullon, Roth, Thrombinemia during percutaneous transluminal angioplasty of chronic femoral artery occlusions, VASA, 15, pp. 379-386, (1986)
[16] Brommer, Engbers, van der Laarse, Nieuwenhuizen, Survival of fibrinogen degradation products in the circulation after thrombolytic therapy for acute myocardial infarction, Fibrinolysis, 1, pp. 149-153, (1987)
[17] Kaufman, Barth, Kadir, Et al., Hemodynamic measurements in the evaluation and follow-up of transluminal angioplasty of the iliac and femoropopliteal artery, Radiology, 142, pp. 329-336, (1982)
[18] Probst, Cerny, Owens, Mahler, Patency after femoral angioplasty: correlation of angiographic appearance with clinical findings, AJR, 140, pp. 1227-1232, (1983)
[19] Jeans, Armstrong, Cole, Horrocks, Baird, Fate of patients undergoing transluminal angioplasty for lower-limb ischemia, Radiology, 177, pp. 559-564, (1990)
[20] Legnani, MacCaerri, Palareti, Coccheri, New quantitative enzyme immunoassays for degradation products of fibrin and fibrinogen in plasma: a comparison with other laboratory methods, Fibrinolysis, 4, pp. 189-193, (1990)

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