Changes in plasma fibrin degradation products as a marker of thrombus evolution in patients with deep vein thrombosis

In 49 patients the level of plasma fibrin degradation products (FbDP) was measured during the first ten days of deep vein thrombosis (DVT) in order to determine whether FbDP may be used as a non invasive marker to follow the evolution of DVT. Plasma FbDP was measured precisely and reliably by Elisa using a personal anti D neo monoclonal antibody. Thrombus size was determined angiographically on day 0 and day 10 and expressed according to Marder score. Patients were treated by standard or by a very low molecular weight heparin (CY 222 from Choay Laboratory, Paris France).It is shown that before treatment, in 45 cases of DVT the level of FbDP was dramatically increased as compared to control and remained normal or slightly elevated in 4 cases of DVT. The correlation between thrombus size and FbDP level at day 0 was poor (p = 0.3). During the 10 days of treatment, FbDP determination may give some informations about the evolution of DVT. Three groups were defined :1 There was no reduction of thrombus size in patients who presented a normal or only slightly elevated FbDP level, leading to the evidence that thrombolysis was almost inexistant in these patients.2 Thrombolysis was almost complete in 10 days in patients presented both a high FbDP level before treatment and a dramatic decrease of FbDP after 10 days treatment. Taking into account the half life of FbDP, the decrease in FbDP level is related to the reduction in thrombus size.3 A partial or absence of recanalization was evidenced in patients presenting a high FbDP level throughout the 10 days on therapy. In cases without recanalization we have to assume that thrombolysis evidenced by plasma FbDP level was continuously counteract by a clotting process.Similar results were observed in patient treated by standard and CY 222.

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193 Determination of specific plasma fibrin degradation products in patients with pulmonary embolism associated with deep-vein thrombosis treated by fibrinolytic agents

Fibrinolysis and Proteolysis ◽

10.1016/0268-9499(88)90540-1 ◽

1988 ◽

Vol 2 ◽

pp. 82

Author(s):

R. Faivre ◽

Manouchr Mirshahi ◽

D. Ducellier ◽

F. Bildstein ◽

C. Soria ◽

...

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Degradation Products ◽

Fibrinolytic Agents ◽

Vein Thrombosis ◽

Fibrin Degradation Products ◽

Deep Vein

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FIBRIN/FIBRINOGEN DEGRADATION PRODUCTS AND DEEP-VEIN THROMBOSIS

The Lancet ◽

10.1016/s0140-6736(72)90448-5 ◽

1972 ◽

Vol 299 (7751) ◽

pp. 640-641

Author(s):

J.D. Cash ◽

P.C. Das ◽

C.V. Ruckley ◽

A.A. Donaldson ◽

W.A. Copland ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Degradation Products ◽

Fibrinogen Degradation Products ◽

Vein Thrombosis ◽

Deep Vein

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A Pilot Study of Subcutaneous Recombinant Hirudin (HBW 023) in the Treatment of Deep Vein Thrombosis

Thrombosis and Haemostasis ◽

10.1055/s-0038-1642482 ◽

1994 ◽

Vol 71 (05) ◽

pp. 558-562 ◽

Cited By ~ 28

Author(s):

F Schiele ◽

A Vuillemenot ◽

Ph Kramarz ◽

Y Kieffer ◽

J Soria ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Plasma Levels ◽

Degradation Products ◽

Subcutaneous Administration ◽

Pulmonary Angiography ◽

Heparin Therapy ◽

Hemorrhagic Complication ◽

Recombinant Hirudin ◽

Vein Thrombosis ◽

Deep Vein

SummaryBackground: Recombinant hirudin, a pure, specific antithrombin could be more effective than heparin in the treatment of deep vein thrombosis, but its short half-life requires constant intravenous infusion, whereas subcutaneous administration of recombinant hirudin can ensure stable and prolonged plasma levels. The aim of our study was to assess the pharmacokinetics, the results on the coagulation variables, and the safety of a recombinant hirudin (HBW 023) administered subcutaneously in patients suffering from deep vein thrombosis.Methods: Recombinant hirudin (HBW 023) was administered subcutaneously to 10 patients with recent deep vein thrombosis, at a dose of 0.75 mg/kg of body weight twice daily for 5 days, after which standard heparin and acenocoumarol were introduced. Bilateral lower limb venography, and pulmonary angiography, and/or ventilation-perfusion lung scan were carried out on day 1 prior to recombinant hirudin injection and repeated on day 5. aPTT and recombinant hirudin plasma levels were serially assessed after the 1st and the 10th injections. Prothrombin fragments 1 + 2, thrombin-antithrombin III complexes, fibrin degradation products were collected on days 1 and 5.Results: Clinical evolution was uneventful in all but one patient who had a probable recurrence of pulmonary embolism on day 4. No hemorrhagic complication, no untoward biological event was observed. On days 5, Mardcr score was unchanged or had decreased. Plasma levels of recombinant hirudin peaked in between 3 and 4 h following the injection. aPTT values paralleled, and were significantly correlated with plasma levels of recombinant hirudin on day 1 as well on day 5 (r = 0.903, r = 0.948 respectively). Fragment 1 + 2, and thrombin antithrombin complexes non-significantly decreased from day 1 to day 5.Conclusions: Subcutaneous administration of recombinant hirudin ensures prolonged stable plasma levels of recombinant hirudin which results in efficient anticoagulation. A dose-ranging study conducted with subcutaneous recombinant hirudin in comparison to conventional heparin therapy may answer the question as to efficacy.

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Intermittent Infusions Of Arvin And Low-Dose Urokinase In The Treatment Of Deep Vein Thrombosis

10.1055/s-0038-1653164 ◽

1981 ◽

Author(s):

M K Dubiel ◽

M F Scully ◽

R Ham ◽

B Djazaeri ◽

V V Kakkar

Keyword(s):

Deep Vein Thrombosis ◽

Low Dose ◽

Fibrinogen Level ◽

Degradation Products ◽

The Other ◽

Blood Samples ◽

Bolus Infusion ◽

Vein Thrombosis ◽

Preliminary Study ◽

Deep Vein

A preliminary study has been made on the thrombolytic therapy effectivity in seven patients with deep vein thrombosis, undergoing intermittent arvin/urokinase therapy. On the first day, patients received an infusion of 70 units of arvin over a period of 6 hours, followed by a bolus infusion of 70 units of arvin and half an hour later, a bolus infusion of 250,000 units of urokinase. After 6 hours 35 units of arvin were administered over a six hourly period followed by a bolus infusion of 250,000 units of urokinase. Subsequent four days consited of a six hourly infusion of 35 units of arvin followed by a bolus infusion of 250,000 units of urokinase. Urokinase dose was repeated twice at 8 hourly intervals. Blood samples were collected each day, pre arvin, post arvin and post first dose of urokinase.No haemorrhagic complications were observed. Two out of four patients with incomplete occlusive thrombi showed 100% lysis, in the other two no lysis occurred. The three patients with complete occlusive thrombi showed no lysis.After the initial infusion of arvin, circulating clottable fibrinogen fell to ≃35% of the preinfusion level. Urokinase had a small effect on the fibrinogen level reducing it to 12% of the preinfusion level. Plasma concentration of fibrinogen degradation products initially rose to levels >3 mg/ml but dropped to lower levels remaining there throughout the treatment. On the first day of treatment plasminogen levels dropped by ≃60% and antiplasmin levels by ≃80% of the pretreatraent level, after the administration of arvin and urokinase. Levels of urokinase rose to > 0.3u/ml post treatment but fell to≃0.01u/ml in the pretreatment samples.These results suggest that this type of treatment involving a defibrinogenating agent arvin, and a plasminogen activator urokinase, may constitute a safe and effective way of lysing non-occlusive deep vein thrombin without any associated haemorrhagic complications.

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FIBRIN/FIBRINOGEN DEGRADATION PRODUCTS AND DEEP-VEIN THROMBOSIS

The Lancet ◽

10.1016/s0140-6736(72)90265-6 ◽

1972 ◽

Vol 299 (7753) ◽

pp. 748-749

Author(s):

C.R.M. Prentice ◽

E.H. Wood ◽

G.P. Mcnicol

Keyword(s):

Deep Vein Thrombosis ◽

Degradation Products ◽

Fibrinogen Degradation Products ◽

Vein Thrombosis ◽

Deep Vein

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