An Activated State of Blood Coagulation and Fibrinolysis in Patients with Abdominal Aortic Aneurysm

Yamazumi, Kensuke; Ojiro, Masataka; Okumura, Hiroshi; Aikou, Takashi

doi:10.1016/s0002-9610(98)00014-2

Cited by 107 publications

(16 citation statements)

References 23 publications

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“…stated that TF level in 36 patients undergoing elective surgery due to non-ruptured aneurysms does not depend on the aneurysm size and does not correlate with other exponents of the hemostasis process. However, the researchers observed a correlation between TFPI level and aneurysmal size and levels of TAT, D-dimers, fibrinogen degradation products, and α2 plasminogen inhibitor [29]. Nomura et al .…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of tissue factor in patients with abdominal aortic and iliac arterial aneurysms – preliminary study

Skóra¹,

Dawiskiba²,

Zaleska³

et al. 2013

aoms

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IntroductionThe decision on the time and choice of strategy of treatment of abdominal aortic aneurysm must be especially carefully balanced. The aim of the study was to evaluate the tissue factor (TF) plasma level as a potential factor useful in anticipation of abdominal aortic aneurysm and/or iliac arterial aneurysm via comparison of plasma TF level in patients with ruptured and non-ruptured aneurysms.Material and methodsThe study included 33 patients with aneurysm (17 operated on electively because of non-ruptured aneurysm and 16 operated on emergently due to ruptured aneurysm), 33 claudicant patients with atherosclerosis of the abdominal aorta and iliac arteries with normal diameter of arteries, and 30 healthy controls. Plasma TF level was assessed by ELISA method using the IMUBIND Tissue Factor ELISA Kit (American Diagnostica Inc.).ResultsThe study showed an increased TF level in patients with aneurysm (134 ±54 pg/ml) and in patients with atherosclerosis without concomitant aneurysm (91 ±30 pg/ml) in comparison with the control group (62 ±20 pg/ml), respectively p < 0.001 and p = 0.008. A significantly higher TF plasma level was observed in patients with ruptured abdominal aortic aneurysms (160 ±57 pg/ml) as compared to patients with non-ruptured aortic aneurysms (109 ±39 pg/ml) or peripheral arterial occlusive disease (91 ±30 pg/ml), respectively p < 0.001 and p < 0.001. The difference in TF level between the group with non-ruptured aortic aneurysms (109 ±39 pg/ml) and the patients with atherosclerosis without aneurysm (91 ±30 pg/ml) was not statistically significant.ConclusionsNo difference in TF level between patients with non-ruptured AAA/IAA and patients with aortic and iliac atherosclerosis without aneurysm indicates that an increased TF plasma level is not specific for any of the above-mentioned vascular pathologies.

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Section: Discussionmentioning

confidence: 99%

Prognostic value of tissue factor in patients with abdominal aortic and iliac arterial aneurysms – preliminary study

Skóra¹,

Dawiskiba²,

Zaleska³

et al. 2013

aoms

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“…Circulating plasmin–anti-plasmin complexes 105 are particularly sensitive in AAA, associated or not with fibrin degradation products. 106 It has been recently reported that plasmin–anti-plasmin and D-dimers 107 were correlated with aortic diameter, ILT thickness, aneurysmal growth, and also with decreased pulmonary function 108 in patients with AAA. 109,110 …”

Section: Applications To Diagnosismentioning

confidence: 96%

Novel aspects of the pathogenesis of aneurysms of the abdominal aorta in humans

Michel

Martin-Ventura

Egido

et al. 2010

Cardiovascular Research

318

273

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Aneurysm of the abdominal aorta (AAA) is a particular, specifically localized form of atherothrombosis, providing a unique human model of this disease. The pathogenesis of AAA is characterized by a breakdown of the extracellular matrix due to an excessive proteolytic activity, leading to potential arterial wall rupture. The roles of matrix metalloproteinases and plasmin generation in progression of AAA have been demonstrated both in animal models and in clinical studies. In the present review, we highlight recent studies addressing the role of the haemoglobin-rich, intraluminal thrombus and the adventitial response in the development of human AAA. The intraluminal thrombus exerts its pathogenic effect through platelet activation, fibrin formation, binding of plasminogen and its activators, and trapping of erythrocytes and neutrophils, leading to oxidative and proteolytic injury of the arterial wall. These events occur mainly at the intraluminal thrombus–circulating blood interface, and pathological mediators are conveyed outwards, where they promote matrix degradation of the arterial wall. In response, neo-angiogenesis, phagocytosis by mononuclear cells, and a shift from innate to adaptive immunity in the adventitia are observed. Abdominal aortic aneurysm thus represents an accessible spatiotemporal model of human atherothrombotic progression towards clinical events, the study of which should allow further understanding of its pathogenesis and the translation of pathogenic biological activities into diagnostic and therapeutic applications.

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“…However, our patient showed temporary improvement for a few weeks, which led us to assume that an atheroma from the shaggy aorta or the arch aneurysm was responsible for the recurrence. Pathogenesis of DIC-associated AAA includes exposure of the denuded aortic endothelial surface [1] and a thrombus being a source of local fibrinolysis [13]. Fortunately, our patient did not show any clinically apparent bleeding tendency and DIC gradually alleviated without medical treatment.…”

Section: Discussionmentioning

confidence: 76%

Lessons Learned from a Case of Abdominal Aortic Aneurysm Accompanied by Unstable Coagulopathy

Hoshina

Kaneko

Hosaka

et al. 2012

Case Reports in Vascular Medicine

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Preoperative examination for abdominal aortic aneurysms (AAAs) occasionally reveals an abnormal decrease in coagulation factors and thrombocytopenia, fulfilling the criteria for disseminated intravascular coagulation (DIC). Treatment of the underlying disorder is indispensable for alleviating DIC. We report an uncommon case of a patient with AAA and DIC who showed prolonged thrombocytopenia despite successful treatment of AAA and temporary recovery of coagulation factors. A 70-year-old man presented with AAA and shaggy aorta accompanied by DIC and underwent aneurysmectomy. Combined preoperative use of nafamostat mesilate and recombinant human soluble thrombomodulin was effective in controlling DIC. Although recovery of coagulation factors was observed after surgery, the thrombocytopenia continued throughout the postoperative course and was refractory to platelet transfusion. Because HPA antibody and PA-IgG were present, a trial administration of γ-globulin was performed; this resulted in rapid improvement of thrombocytopenia. Although DIC recurred again 2 weeks thereafter, coagulation factors subsequently recovered without any medication.

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An Activated State of Blood Coagulation and Fibrinolysis in Patients with Abdominal Aortic Aneurysm

Cited by 107 publications

References 23 publications

Prognostic value of tissue factor in patients with abdominal aortic and iliac arterial aneurysms – preliminary study

Prognostic value of tissue factor in patients with abdominal aortic and iliac arterial aneurysms – preliminary study

Novel aspects of the pathogenesis of aneurysms of the abdominal aorta in humans

Lessons Learned from a Case of Abdominal Aortic Aneurysm Accompanied by Unstable Coagulopathy

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