D-Dimer in Local Thrombolytic Therapy with Low Doses of Recombinant Human Tissue-Type Plasminogen Activator (rt-PA) in Patients with Peripheral Arterial Occlusive Disease

Renate Koppensteiner; Wolfgang Speiser; Erich Minar; Ramazan Ahmadi; Herbert Ehringer

doi:10.1055/s-0038-1647283

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 1990; 64(02): 192-195
DOI: 10.1055/s-0038-1647283

Original Article

Schattauer GmbH Stuttgart

D-Dimer in Local Thrombolytic Therapy with Low Doses of Recombinant Human Tissue-Type Plasminogen Activator (rt-PA) in Patients with Peripheral Arterial Occlusive Disease

Renate Koppensteiner

The First Department of Medicine, Division of Angiolog, University of Vienna, Vienna, Austria

,

Wolfgang Speiser

^*The Division of Hematology and Hemostaseology, University of Vienna, Vienna, Austria

,

Erich Minar

The First Department of Medicine, Division of Angiolog, University of Vienna, Vienna, Austria

,

Ramazan Ahmadi

The First Department of Medicine, Division of Angiolog, University of Vienna, Vienna, Austria

,

Herbert Ehringer

The First Department of Medicine, Division of Angiolog, University of Vienna, Vienna, Austria

› Institutsangaben

Abstract

als PDF herunterladen

Summary

The generation of D-dimer was studied in the course of local thrombolytic therapy of peripheral arterial occlusions with low doses of recombinant human tissue-type plasminogen activator (rt-PA) in 7 patients. Intermittent local application of rt-PA resulted in a marked increase in D-dimer exceeding values usually seen after intravenous application of manifold higher doses used in myocardial infarction. The increase in D-dimer was related to the estimated thrombus size (length of the occlusion) and the total dose of rt-PA applied. During local rt-PA infusion 6 of 7 patients maintained plasminogen activator inhibitor capacity (PAI-cap) between 34% and 79% of their corresponding pre-treatment levels; detectable levels of PAI-cap in circulating blood during the procedure did not interfere with the success of therapy.

PDF (386 kb)

Referenzen

References
1 Whitaker AN, Elmas MJ, Masci PP, Bundesen PG, Rylatt DB, Webber AJ, Bunce IH. Measurement of cross linked fibrin derivates in plasma: an immunoassay using monoclonal antibodies. J Clin Pathol 1984; 37: 882-887
2 Rowbotham BJ, Carroll P, Whitaker AN, Bunce IH, Cobcroft RG, Elms MJ, Masci PP, Bundesen PG, Rylatt DB, Webber AJ. Measurement of crosslinked fibrin derivates - use in the diagnosis of venous thrombosis. Thromb Haemostas 1987; 57 (01) 59-61
3 Faivre R, Mirshani M, Ducellier D, Soria C, Mirshani M, Kiffer Y, Bassand P, Caen J, Maurat JP. Evolution of plasma specific fibrin degradation products during thrombolytic therapy in patients with thromboembolism. Thromb Res 1988; 50: 583-589
4 Lew AS, Berberian FL, Cercek AB, Lee St, Sah PK, Ganz FW. Elevated serum d-dimer: a degradation product of cross linked fibrin (XDP) after intravenous streptokinase during acute myocardial infarction. J Am Coll Cardiol 1986; 7: 1320-1324
5 Declerk P, Mombaerts P, Holvoet P, Collen D. Plasma levels of fragment d-dimer of crosslinked fibrin during thrombolytic therapy with recombinant tissue-type plasminogen activator. Thromb Haemostas 1987; 58: 231 (Abstr)
6 Eisenberg PR, Sherman LA, Tiefenbrunn AJ, Ludbrook PA, Sobel BE, Jaffe AS. Sustained fibrinolysis after administration of t-PA despite its short half-life in the circulation. Thromb Haemostas 1987; 57 (01) 35-40
7 Roth R, Cuckert F, Marbet G. D-dimers: a monitoring parameter in thrombolysis. Thromb Haemostas 1987; 58: 98 (Abstr)
8 Koppensteiner R, Minar E, Ahmadi R, Jung M, Ehringer H. Low doses of recombinant human tissue-type plasminogen activator for local thrombolysis in peripheral arteries. Radiology 1988; 168: 877 (Letter)
9 Hess H, Mietaschk A, Becker-Lienau C. Fibrinolyse mit rt-PA bei peripheren arteriellen Verschlussen. Klin Wschr 1988; 66 XII 135-136
10 Korninger C, Speiser W, Wojta J, Binder BR. Sandwich elisa for t-PA antigen employing a monoclonal antibody. Thromb Res 1986; 527-535
11 Speiser W, Bowry S, Anders E, Binder BR, Muller-Berghaus G. Method for the determination of fast acting plasminogen activator inhibitor capacity (PAI-cap) in plasma, platelets and endothelial cells. Thromb Res 1986; 44: 503-515
12 Hess H, Ingrisch H, Mietaschk A, Rath H. Local low-dose thrombolytic therapy of peripheral arterial occlusions. N Engl J Med 1982; 307 (26) 1627-1630
13 Seifried E, Tanswell P, Rijken DC, Kluft C, Hobgee E, Nieuwenhuizen W. Fibrin degradation products are not specific markers for thrombolysis in myocardial infarction. Lancet 1987; II: 333-334
14 Greenberg ChS, Devine DV, McCrae KM. Measurement of plasma fibrin D-dimer with the use of a monoclonal antibody coupled to latex beads. Am J Clin Pathol 1987; 87: 94-100
15 Franks JJ, Kirsch RE, Kao B, Kloppel TM. Fibrinogen and fibrinogen related peptides in cancer. In: Mariani G. (ed) Pathophysiology of plasma protein metabolism MacMillan. London: 1984: 265-269
16 Paramo JA, Colucci M, Collen D. Plasminogen activator inhibitor in the blood of patients with coronary artery disease. Br Med J 1985; 291: 573-574
17 Hamsten A, Wiman B, De FaireU, Blomback M. Increased plasma levels of a rapid inhibitor of tissue plasminogen activator in young survivors of myocardial infarction. N Engl J Med 1985; 313: 1557-1563
18 Hoenigl K, Pilger E, Stark G, Bertuch H. Fibrinolytische Therapie -Plasminogenaktivatorinhibitoren. Vasa 1988; (Suppl. 26) 103-106
19 Kruithof E KO, Tran-Thang C, Ransijn A, Bachmann F. Demonstration of a fast-acting inhibitor of plasminogen activators in human plasma. Blood 1984; 64: 907-913