Paget Schroetter Patients with Chronic Venous Occlusion Benefit from Surgical Decompression

SummaryWe analyzed fibrinolytic parameters in 20 healthy men and 20 healthy women, aged from 25 to 59, before and after 10 and 20 min venous occlusion. The 10 min post-occlusion fibrinolytic activity measured directly in diluted unfractionated plasma by a highly sensitive 125I-fibrin plate assay correlated well with the activity of euglobulins determined by the classical fibrin plate assay (r = 0.729), but pre-stasis activities determined with these two methods did not correlate (r = 0.084). The enhancement of fibrinolytic activity after venous occlusion was mainly due to an increase of t-PA in the occluded vessels (4-fold increase t-PA antigen after 10 min and 8-fold after 20 min venous occlusion). Plasminogen activator inhibitor (PAI) activity and plasminogen activator inhibitor 1 (PAI-1)1 antigen levels at rest showed considerable dispersion ranging from 1.9 to 12.4 U/ml, respectively 6.9 to 77 ng/ml. A significant increase of PAI-1 antigen levels was observed after 10 and 20 min venous occlusion. At rest no correlation was found between PAI activity or PAI-1 antigen levels and the fibrinolytic activity measured by 125I-FPA. However, a high level of PAI-1 at rest was associated with a high prestasis antigen level of t-PA and a low fibrinolytic response after 10 min of venous stasis. Since the fibrinolytic response inversely correlated with PAI activity at rest, we conclude that its degree depends mainly on the presence of free PAI.

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Studies on the Fibrinolytic System in Human Plasma: Quantitative Determination of Plasminogen Activators and Proactivators

Thrombosis and Haemostasis ◽

10.1055/s-0038-1646786 ◽

1979 ◽

Vol 41 (02) ◽

pp. 365-383 ◽

Cited By ~ 80

Author(s):

C Kluft

Keyword(s):

Pilot Study ◽

Plasma Level ◽

Human Plasma ◽

Plasminogen Activators ◽

Venous Occlusion ◽

Quantitative Information ◽

Optimal Recovery ◽

Dextran Sulphate ◽

Baseline Levels

SummaryEffects due to plasma plasminogen activators and proactivators are usually studied in assay systems where inhibitors influence the activity and where the degree of activation of proactivators is unknown. Quantitative information on activator and proactivator levels in plasma is therefore not availableStudies on the precipitating and activating properties of dextran sulphate in euglobulin fractionation presented in this paper resulted in the preparation of a fraction in which there was optimal recovery and optimal activation of a number of plasminogen activators and proactivators from human plasma. The quantitative assay of these activators on plasminogen-rich fibrin plates required the addition of flufenamate to eliminate inhibitors. The response on the fibrin plates (lysed zones) could be coverted to arbitrary blood activator units (BAU). Consequently, a new activator assay which enables one to quantitatively determine the plasma level of plasminogen activators and proactivators together is introduced.Two different contributions could be distinguished: an activity originating from extrinsic activator and one originating from intrinsic proactivators. The former could be assayed separately by means of its resistance to inhibition by Cl-inactivator. Considering the relative concentrations of extrinsic and intrinsic activators, an impression of the pattern of activator content in plasma was gained. In morning plasma with baseline levels of fibrinolysis, the amount of extrinsic activator was negligible as compared to the level of potentially active intrinsic activators. Consequently, the new assay nearly exclusively determines the level of intrinsic activators in morning plasma. A pilot study gave a fairly stable level of 100 ± 15 BAU/ml (n = 50). When fibrinolysis was stimulated by venous occlusion (15 min), the amount of extrinsic activator was greatly increased, reaching a total activator level of 249 ± 27 BAU/ml (n = 7).

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A Plasma Clot Lysis Assay Based on the Release of Fibrin Degradation Products: Application to the Diagnosis of Hypofibrinolytic States

Thrombosis and Haemostasis ◽

10.1055/s-0038-1645690 ◽

1990 ◽

Vol 63 (01) ◽

pp. 076-081 ◽

Cited By ~ 2

Author(s):

Pascale Gaussem ◽

Sophie Gandrille ◽

Pascale Molho-Sabatier ◽

Loïc Capron ◽

Jean-Noël Fiessinger ◽

...

Keyword(s):

Degradation Products ◽

Venous Occlusion ◽

Lower Limbs ◽

Clot Lysis ◽

Plasma Clot ◽

Vein Thrombosis ◽

Fibrin Degradation Products ◽

Before And After ◽

Euglobulin Clot Lysis Time ◽

Pai 1

SummaryUsing a monoclonal antibody-based assay, we measured the fibrin degradation product release in the supernatant of plasma clots obtained before and after venous occlusion (VO) in 30 patients with definite or suspected vascular thrombosis (19 definite and 2 suspected deep vein thrombosis, 6 recurrent superficial thrombophlebitis, 3 arterial occlusions of lower limbs). tPA and PAI-1 concentrations were determined using ELISA assays; the post-occlusion values were corrected for haemoconcentration. The increase in tPA during VO was correlated with haemoconcentration (r = 0.74), but 3 patients had ineffective VO (<2% increase in proteins). The fibrinolytic response to VO was evaluated using the shortening of the time necessary for the release of 200 μg of fibrin degradation products per mg of fibrinogen (Δ T 200). Two among the 27 patients with effective VO were bad responders with a Δ T 200 <3 h (whereas all the others had Δ T 200 >10 h). These patients had respectively a deficient tPA release (Δ tPA = 1 ng/ml) and an elevated PAI-1 level at rest (33 ng/ml). Several other patients were bad responders in terms of tPA release or of shortening of the euglobulin clot lysis time but they had a normal Δ T 200. This plasma clot test reflects the ability of free tPA to bind to fibrin (the amount of which depends on the level of tPA and PAI-1), and may be useful in the diagnosis of a hypofibrinolytic state.

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Venous Occlusion Does Not Release von Willebrand Factor, Factor VIII or PAI-1 from Endothelial Cells – The Importance of Consensus on the Use of Correction Factors for Haemoconcentration

Thrombosis and Haemostasis ◽

10.1055/s-0038-1651559 ◽

1993 ◽

Vol 69 (01) ◽

pp. 091-091 ◽

Cited By ~ 15

Author(s):

Iwona Wieczorek ◽

Christopher A Ludlam ◽

Ian MacGregor

Keyword(s):

Endothelial Cells ◽

Factor Viii ◽

Von Willebrand Factor ◽

Venous Occlusion ◽

Correction Factors ◽

Von Willebrand ◽

Willebrand Factor ◽

Pai 1

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The Effect of Venous Occlusion on the Sequestration of Blood Platelets

Thrombosis and Haemostasis ◽

10.1055/s-0038-1649022 ◽

1972 ◽

Vol 28 (03) ◽

pp. 383-392 ◽

Cited By ~ 1

Author(s):

J Hladovec ◽

Z Koleilat ◽

I Přerovský

Keyword(s):

Blood Platelets ◽

Venous Blood ◽

Venous Occlusion ◽

Blood Samples ◽

Pronounced Decrease ◽

Platelet Counts ◽

Human Volunteers ◽

Opposite Change

SummaryThe venous occlusion of all four legs in rats caused a highly significant decrease of platelet counts in venous blood especially after the correction for an opposite change in haematocrit. A very pronounced decrease in platelets was observed in human volunteers after a venostasis in one arm in the blood drawn from the occluded limb just before the release of occlusion. Similar decreases were found after a venostasis of both legs in postocclusion blood samples. The decrease in blood platelets results from temporary sequestration in the occluded limbs. The decreases of platelets after a 10 min occlusion of both legs are more pronounced in patients with post thrombotic states.

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