Coagulation, fibrinolysis, and platelet activation in patients undergoing open and endovascular repair of abdominal aortic aneurysm

Abstract

The resultant prothrombotic diathesis after open surgical repair and EVAR may account for the high level of perioperative thrombotic complications.

Changes in thrombin generation, fibrinolysis, platelet and endothelial cell activity, and inflammation following endovascular abdominal aortic aneurysm repair

“…27,28 The present study confirms that patients with asymptomatic AAA exhibit a prothrombotic diathesis characterized by excessive thrombin generation as shown by markedly elevated PF1 ϩ 2 and TAT prior to EVAR. 4,15,17,[19][20][21][22] However, unlike some previous studies, no correlation was found between TAT, PF1 ϩ 2, and aneurysm diameter in this cohort.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] A recent work from this group has shown that patients with AAA exhibit increased thrombin generation and activity as well as increased fibrin turnover. 15 Although these derangements appear to be correlated with aneurysm size, 14 increased fibrin turnover is also found in patients with small AAA. 1 This may show that hemostatic derangement is related to the size of intrasac thrombus than aneurysm size.…”

“…16 Both open surgical (OR) and endovascular (EVAR) repair of AAA are associated with increased thrombin generation and relative hypofibrinolysis in the immediate perioperative period. 13,15,[17][18][19][20][21] The resultant prothrombotic diathesis after OR and EVAR may account for the high level of peri-operative thrombotic complications. 15 It was found that the hemostatic response is significantly reduced in the long term following OR but not normalized.…”

“…13,15,[17][18][19][20][21] The resultant prothrombotic diathesis after OR and EVAR may account for the high level of peri-operative thrombotic complications. 15 It was found that the hemostatic response is significantly reduced in the long term following OR but not normalized. 22 However, it remains unclear what happens in the long term following EVAR and what the clinical consequences of these hemostatic abnormalities might be for patients.…”

Activity of thrombin-activatable fibrinolysis inhibitor in the plasma of patients with abdominal aortic aneurysm

“…AAA patients experience intensified plasma fibrinolysis and increased concentration of prothrombotic factors. Their blood exhibits elevated levels of D-dimers (fibrin fragments), PAI-1 (plasminogen activator inhibitor type-1),thrombin-antithrombin complexes, F1þ2 (prothrombin fragments) [7,9,10]. Haemostatic abnormalities are further aggravated by inflammatory processes associated with the aneurysm.…”