Coagulation alterations due to local fibrinolytic therapy with recombinant tissue-type plasminogen activator (rt-PA) in patients with peripheral arterial occlusive disease

Rauber, Klaus; Heidinger, Kathrin S; Kemkes-Matthes, Bettina

doi:10.1007/S002709900131

Title: Coagulation alterations due to local fibrinolytic therapy with recombinant tissue-type plasminogen activator (rt-PA) in patients with peripheral arterial occlusive disease

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Abstract

Purpose. To determine the systemic effects of local fibrinolytic therapy with low-dose recombinant tissue-type plasminogen activator (rt-PA). Methods. Ten patients received intrathrombal infusion of 20 mg rt-PA and heparin for local thrombolysis and had subsequent percutaneous transluminal angioplasty (PTA). Eight controls underwent PTA and received heparin alone. We measured t-PA, D-Dimer, and fibrinogen levels before, directly after, and 20, 40, and 60 min and 24 hr after therapy. Results. In the thrombolysis group the t-PA level peaked immediately after infusion and then declined within 1 hr. D-Dimer increased and remained elevated, whereas in the control group only t-PA levels increased, and only after 24 hr. Fibrinogen remained within the normal range in both groups. Eight of ten patients in the thrombolysis group and seven of eight with PTA had clinical improvement after the procedure. Conclusions. The increase in D-Dimer in the rt-PA group indicates a good local fibrinolytic effect. The fact that fibrinogen levels remained unchanged indicates that there is a lack of systemic fibrinogenolysis.

Authors:

Rauber, Klaus ^[1]; Heidinger, Kathrin S; Kemkes-Matthes, Bettina ^[2]

Justus-Liebig University Giessen, Department of Radiology (Germany)
Justus-Liebig University Giessen, Department of Internal Medicine (Germany)

Publication Date:: Thu May 15 00:00:00 EDT 1997

OSTI Identifier:: 21080222

Resource Type:: Journal Article

Journal Name:: Cardiovascular and Interventional Radiology

Additional Journal Information:: Journal Volume: 20; Journal Issue: 3; Other Information: DOI: 10.1007/s002709900131; Copyright (c) 1997 Springer-Verlag New York Inc.; Article Copyright (c) 1997 Springer-Verlag New York Inc; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0174-1551

Country of Publication:: United States

Language:: English

Subject:: 62 RADIOLOGY AND NUCLEAR MEDICINE; FIBRINOGEN; HEPARIN; INFUSION; PATIENTS; PLASMINOGEN; THERAPY; VASCULAR DISEASES

Citation Formats


                    Rauber, Klaus, Heidinger, Kathrin S, and Kemkes-Matthes, Bettina. Coagulation alterations due to local fibrinolytic therapy with recombinant tissue-type plasminogen activator (rt-PA) in patients with peripheral arterial occlusive disease.  United States: N. p., 1997. 
        Web.  doi:10.1007/S002709900131.

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                    Rauber, Klaus, Heidinger, Kathrin S, & Kemkes-Matthes, Bettina. Coagulation alterations due to local fibrinolytic therapy with recombinant tissue-type plasminogen activator (rt-PA) in patients with peripheral arterial occlusive disease.  United States.  https://doi.org/10.1007/S002709900131

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                    Rauber, Klaus, Heidinger, Kathrin S, and Kemkes-Matthes, Bettina. 1997.  
        "Coagulation alterations due to local fibrinolytic therapy with recombinant tissue-type plasminogen activator (rt-PA) in patients with peripheral arterial occlusive disease".  United States.  https://doi.org/10.1007/S002709900131.

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@article{osti_21080222,

  title        = {Coagulation alterations due to local fibrinolytic therapy with recombinant tissue-type plasminogen activator (rt-PA) in patients with peripheral arterial occlusive disease},

  author       = {Rauber, Klaus and Heidinger, Kathrin S and Kemkes-Matthes, Bettina},

  abstractNote = {Purpose. To determine the systemic effects of local fibrinolytic therapy with low-dose recombinant tissue-type plasminogen activator (rt-PA). Methods. Ten patients received intrathrombal infusion of 20 mg rt-PA and heparin for local thrombolysis and had subsequent percutaneous transluminal angioplasty (PTA). Eight controls underwent PTA and received heparin alone. We measured t-PA, D-Dimer, and fibrinogen levels before, directly after, and 20, 40, and 60 min and 24 hr after therapy. Results. In the thrombolysis group the t-PA level peaked immediately after infusion and then declined within 1 hr. D-Dimer increased and remained elevated, whereas in the control group only t-PA levels increased, and only after 24 hr. Fibrinogen remained within the normal range in both groups. Eight of ten patients in the thrombolysis group and seven of eight with PTA had clinical improvement after the procedure. Conclusions. The increase in D-Dimer in the rt-PA group indicates a good local fibrinolytic effect. The fact that fibrinogen levels remained unchanged indicates that there is a lack of systemic fibrinogenolysis.},

  doi          = {10.1007/S002709900131},

  url          = {https://www.osti.gov/biblio/21080222},
  journal      = {Cardiovascular and Interventional Radiology},

  issn         = {0174-1551},

  number       = 3,

  volume       = 20,

  place        = {United States},

  year         = {Thu May 15 00:00:00 EDT 1997},

  month        = {Thu May 15 00:00:00 EDT 1997}

}

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