Defective Fibrinolysis in Venous Thrombosis

1981 ◽  
Vol 26 (1_suppl) ◽  
pp. S15-S19
Author(s):  
J. A. Davies ◽  
A. J. Crandon ◽  
G. P. McNicol
Keyword(s):  
Laboratory Tests ◽  
Varicose Veins ◽  
High Risk Group ◽  
Unexpected Finding ◽  
Vein Thrombosis ◽  
Lysis Time ◽  
Euglobulin Lysis Time ◽  
Clinical Measurements ◽  
Deep Vein ◽  
Low Dose Heparin

In previous studies a variety of attempts have been made to define laboratory tests which could predict patients who would develop deep vein thrombosis post-operatively. Such tests included the partial thromboplastin time, haematocrit and platelet adhesiveness. In this study patients undergoing gynaecological surgery were screened in advance with a panel of clinical measurements and laboratory tests and the development of DVT was noted using 125I-fibrinogen leg scanning. The values for the selected variables were analysed using logistic discrimination. The factors with the greatest prediction were the euglobulin lysis time, age, varicose veins, serum FR-antigen and percentage overweight for height. When this formula was applied to a further group of patients it allowed a ‘high risk’ group to be defined and these were given low-dose heparin with a significant reduction in the incidence of post-operative DVT. An unexpected finding was that patients who smoked cigarettes appeared to be protected from post-operative DVT.

4G/5G Polymorphism of PAI-1 Gene Promoter and Fibrinolytic Capacity in Patients with Deep Vein Thrombosis

1998 ◽  
Vol 80 (12) ◽  
pp. 956-960 ◽  
Author(s):  
Maria Teresa Sartori ◽  
Björn Wiman ◽  
Silvia Vettore ◽  
Francesco Dazzi ◽  
Antonio Girolami ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Healthy Subjects ◽  
Gene Promoter ◽  
Insertion Polymorphism ◽  
Vein Thrombosis ◽  
Lysis Time ◽  
Euglobulin Lysis Time ◽  
Deep Vein ◽  
Fibrinolytic Capacity ◽  
Pai 1

SummaryA deletion/insertion polymorphism (4G or 5G) in the promoter of the plasminogen activator inhibitor type 1 gene has been suggested to be involved in regulation of the synthesis of the inhibitor, the 4G allele being associated with enhanced gene expression. A relationship between 4G/5G polymorphism and PAI-1 levels was found in patients with cardiovascular and metabolic diseases, but not in healthy subjects. In the present work we studied the distribution of PAI-1 4G/5G geno-type and its relation to fibrinolytic capacity in 70 unrelated patients with deep vein thrombosis. Each patient was assayed before and after 20 min. Venous occlusion for euglobulin lysis time, t-PA antigen and activity, and PAI-1 antigen and activity. The prevalence of 5G homozygous carriers was significantly lower in patients than in controls (10% vs. 26%, p = 0.009). The 5G allele frequency was reduced, even though not significantly, in DVT patients compared to healthy subjects (0.40 vs. 0.51, respectively). In the patient group, the mean PAI-1 antigen and activity levels were significantly higher than among controls and related to the 4G/5G polymorphism. In patients with 4G/5G and 4G/4G genotype a significant correlation was found between PAI-1 levels and the global fibrinolytic activity as evaluated by euglobulin lysis time. The prevalence of a reduced fibrinolytic potential due to PAI-1 excess was 45.7% among DVT patients. Moreover, the prevalence of PAI-1 induced hypofibrinolysis was strongly related to PAI-1 polymorphism, since it was significantly lower in 5G homo-zygous patients (28.6%) than in both 4G/5G carriers (55.3%, p <0.001) and 4G homozygous patients (57.9%, p <0.001).In conclusion, in patients with deep vein thrombosis the 4G polymorphism of PAI-1 gene promoter may influence the expression of PAI-1 and it should be taken into consideration as a facilitating condition for pathological fibrinolysis together with other environmental and genetic factors. Whether this has any significance in regard to the pathogenesis of venous thrombosis remains to be proven.

scholarly journals Postoperative Changes in the Plasmatic Levels of Tissue-Type Plasminogen Activator and Its Fast-Acting Inhibitor - Relationship to Deep Vein Thrombosis and Influence of Prophylaxis

1985 ◽  
Vol 54 (03) ◽  
pp. 713-716 ◽  
Author(s):  
J A Páramo ◽  
M J Alfaro ◽  
E Rocha
Keyword(s):  
Plasminogen Activator ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Tissue Type ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Lysis Time ◽  
Type Plasminogen Activator ◽  
Euglobulin Lysis Time ◽  
Deep Vein

SummaryFibrinogen, euglobulin lysis time (ELT), tissue-type plasminogen activator (t-PA) antigen, plasminogen activator inhibitor activity (PA-inhibitor) and α2-antiplasmin (a2-AP) were measured pre- and postoperatively in 60 patients undergoing total hip replacement. Reduced fibrinolytic activity as assessed by the prolongation of euglobulin lysis time, decrease of t-PA and increase of PA-inhibitor and β2-AP could be demonstrated. These changes did not correlate with the postoperative deep vein thrombosis (DVT) diagnosed with the 125I-fibrinogen test. However, preoperative PA-inhibitor activity was significantly higher in patients with postoperative DVT (p <0.01). The prophylactic treatment with aspirin (20 patients) and with heparin plus dihy-droergotamine (20 patients) induced significant changes in some of those parameters.This study shows that the decrease of t-PA and the increase of PA-inhibitor may contribute to the reduced postoperative fibrinolytic activity after total hip replacement. PA-inhibitor level might be a useful marker in evaluating the risk of developing DVT in patients undergoing total hip replacement.

Low-Dose Heparin and Deep-Vein Thrombosis after Total Hip Replacement

1976 ◽  
Vol 36 (01) ◽  
pp. 157-164 ◽  
Author(s):  
P. M Mannucci ◽  
Luisa E. Citterio ◽  
N Panajotopoulos
Keyword(s):  
Deep Vein Thrombosis ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Low Dose ◽  
Control Group ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Deep Vein ◽  
Low Dose Heparin

SummaryThe effect of subcutaneous low-dose heparin on postoperative deep-vein thrombosis (D. V. T.) (diagnosed by the 125I-labelled fibrinogen test) has been investigated in a trial of 143 patients undergoing the operation of total hip replacement. Two randomized studies were carried out: in one the scanning for D.V.T. was carried out daily for 7 days post operatively and in the other for 15 days. In both, the incidence of D.V.T. was significantly lower in the heparin-treated patients (P<0.005). Bilateral D.V.T. was also prevented (P<0.05), through the extension of D.V.T. to the distal veins of the thigh was not significantly reduced. Heparin treatment was, however, followed by a higher incidence of severe postoperative bleeding (P< 0.02) and wound haematoma formation (P< 0.005), and the postoperative haemoglobin was significantly lower than in the control group (P<0.005). A higher number of transfused blood units was also needed by the heparin treated patients (P<0.001).

Sequential Treatment of Deep Leg Vein Thrombosis with Porcine Plasmin and Low Dose Streptokinase

1982 ◽  
Vol 48 (02) ◽  
pp. 190-195 ◽  
Author(s):  
G A Marbet ◽  
R Eichlisberger ◽  
F Duckert ◽  
M A de Silva ◽  
L Biland ◽  
...  
Keyword(s):  
Low Dose ◽  
Significant Negative Correlation ◽  
Sequential Treatment ◽  
Factor V ◽  
Complete Dissolution ◽  
Vein Thrombosis ◽  
Time Treatment ◽  
Lysis Time ◽  
Euglobulin Lysis Time ◽  
Thrombolytic Effect

SummarySequential treatment of deep leg vein thrombosis with porcine plasmin and low dose streptokinase (10,000-20,000 U/h) produces strong systemic fibrinolysis as demonstrated by the sustained decrease of euglobulin lysis time, of thromboplastin time values in percent, fibrinogen and factor V levels. There is a statistically significant negative correlation between thrombolytic results and euglobulin lysis time. Treatment periods below 3 days are unlikely to give satisfactory results. Occluded vein segments with an apparent median age of 4 days including thrombi older than 10 days (20% of cases) are cleared with an average chance of 50%. Complete dissolution of all thrombi proximal to the crural veins has been demonstrated in 47/114 = 41.2%, some thrombolytic effect in 31/114 = 27.2% and treatment failure in 36/114 = 31.6%. The data favour laboratory monitoring of thrombolytic therapy.

Leech Therapy - A unique treatment in Ayurveda

2019 ◽  
Vol 4 (02) ◽  
Author(s):  
Prasadshakti G. Gannur
Keyword(s):  
Blood Circulation ◽  
Skin Diseases ◽  
Varicose Veins ◽  
Blood Stream ◽  
Blood Capillaries ◽  
Analgesic Property ◽  
Vein Thrombosis ◽  
Leech Therapy ◽  
Medicinal Leeches ◽  
Deep Vein

As mentioned in Ayurveda, Rakta itself is life for human being. If it get vitiated (impure) by means of unhealthy food habits and seasonal change is going to induce many disease. There is a unique worm - Leech which is used therapeutically to treat certain diseases induced by impure blood. Medicinal leeches are used for therapeutic purpose; these will suck only impure blood and relieve the symptoms. While sucking leaches leave saliva into the blood stream, which contain many medicinal properties. Out of which Hirudin is the main content which is having very effective anti-coagulant and analgesic property, because of this analgesic property, the process of sucking is painless. Leaches are mainly used in skin diseases as acne, Kusta, Visarpa, recurrent abscess along with these certain diseases which involve impairment of the blood circulation such as varicose veins deep vein thrombosis non healing ulcers and necrosis are also get benefited by leech therapy which improve the blood circulation by stimulating blood capillaries. Hence in this paper the uses of leech therapy are mentioned for the society to get benefited.

Prophylaxis Against Postoperative Thromboembolic Complications. A Comparison Between Dextran 70, Dihydroergotamin Heparin and a Sulphated Polysaccarid

1979 ◽  
Author(s):  
D. Bergqvist ◽  
T. Hallböök ◽  
B. Lindblad
Keyword(s):  
Elective Surgery ◽  
Hip Surgery ◽  
Perfusion Scintigraphy ◽  
X Ray ◽  
Vein Thrombosis ◽  
Dextran 70 ◽  
Postoperative Thrombosis ◽  
Fibrinogen Test ◽  
Deep Vein ◽  
Low Dose Heparin

Dextran 70, a fixed combination of dihydroergotamine and low dose heparin (DHEH) and a sulphated polysaccarid (PZ68B) have been compared for prevention of postoperative thromboembolism. The trial has been prospective with separate randomization of patients undergoing elective general surgery, elective hip surgery and hip frecture surgery. Deep vein thrombosis has teen diagnosed with the 125 I-fibrinogen test. In patients undergoing elective hip surgery pulmonary x-ray and perfusion scintigraphy have been made preoperatively and on postoperative day 7, The patients have been followed for 30 days to detect late fatal pulmonary emboli. 253 patients have been studied -(34 exclusions), the main results being as follows:In conclusion there is a good and equal prophylactic effect against postoperative thrombosis of DHEH and PZ68E in elective surgery, and the two methods are as effective as dextran 70 in hip fracture patients.

The Prophylaxis of Deep Vein Thrombosis with Low-Dose Heparin: A Trial

1974 ◽  
Vol 44 (3) ◽  
pp. 289-291 ◽  
Author(s):  
J. Propsting ◽  
O. Williams ◽  
M. Stathis ◽  
J. F. Mccaffrey
Keyword(s):  
Deep Vein Thrombosis ◽  
Low Dose ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Deep Vein ◽  
Low Dose Heparin

Low Dose Heparin in the Prevention of Deep-Vein Thrombosis after Aortic Bifurcation Graft Surgery

1979 ◽  
Vol 42 (05) ◽  
pp. 1429-1433 ◽  
Author(s):  
J J F Belch ◽  
G D O Lowe ◽  
J G Pollock ◽  
C R M Prentice
Keyword(s):  
Tranexamic Acid ◽  
Low Dose ◽  
Inhibitory Effect ◽  
Intragastric Administration ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Prolonged Duration ◽  
Deep Vein ◽  
Slide Technique ◽  
Low Dose Heparin

SummaryAn optimal inhibition of tissue fibrinolysis, studied by a histochemical fibrin slide technique in the rat stomach, was obtained by administration of tranexamic acid in a dose of 60 mg/100 g body weight. A significant fibrinolysis inhibition was found within 5 min, when tranexamic acid in this dose was given either intravenously or intragastrically. A prolonged duration of fibrinolysis inhibition was observed after intragastric administration. After 4 hr no inhibitory effect of tranexamic acid could be recorded, irrespective of the route of administration.

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