Blood clot parameters: Prejudgment of fibrinolysis in thromboelastography

Mou, Qiongyao; Zhou, Qi; Liu, Shengxiong

doi:10.1016/j.cca.2018.01.023

Cited by 7 publications

(7 citation statements)

References 17 publications

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“…Few of stratification methods were specially built for patients who underwent THA or TKA. Currently, there is a detection technique called thromboelastography (TEG), which is a real-time tool to observe the whole process of blood coagulation and is clinically valuable in the evaluation of whole-blood hemostasis (15).…”

Section: Introductionmentioning

confidence: 99%

The application of thromboelastography in risk stratification for selective thromboembolism prophylaxis after total joint arthroplasty in Chinese: a randomized controlled trial

Chen¹,

Ma²,

Li³

et al. 2020

Ann Palliat Med

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Background: As Asian populations, Chinese have a lower rate of high-risk gene mutations in venous thrombosis. Therefore, individual patient risk assessment, rather than a "blanket policy", is considered the best thromboembolism prophylaxis for Chinese. The purpose of this study was to evaluate the effectiveness and safety of selective thromboembolism prophylaxis compared with conventional thromboembolism prophylaxis by risk stratification with thromboelastography (TEG) after joint arthroplasty in Chinese.Methods: Between August 2016 to August 2017, Chinese patients who underwent hip or knee arthroplasty were randomly divided into a selective anticoagulation group (SAG) and a conventional anticoagulation group (CAG). Participants and outcome assessors were blinded. In the SAG, an anticoagulant was used when TEG indicated hypercoagulability; while in the CAG, an anticoagulant was regularly used until one month after surgery. Outcome evaluation included effectiveness (defined as the incidence of VTE), and safety (defined as the incidence of bleeding events, poor wound healing, blood loss, and infection).Results: A total of 197 patients (79 in the SAG and 118 in the CAG) were included in the study. There was 1 case of deep vein thrombosis (DVT) in the SAG and 2 cases of DVT in the CAG, but there was no significant difference between the two groups. Hidden blood loss in the SAG was 707.4±539.8 mL and hidden blood loss in the CAG was 617±565.0 mL, respectively (P>0.05). No significant difference was observed in perioperative blood loss between the SAG and the CAG (1,024.9±597.9 and 1,139.3±620.9 mL, respectively). Volume of blood transfusion was 92.4±270.2 mL in the SAG and 224.6±416.3 mL in the CAG, respectively, while rate of transfusion was 13.9% in the SAG and 33.9% in the CAG, respectively, which were significantly different between the two groups (P<0.05). Conclusions:In Chinese patients who underwent hip or knee arthroplasty, the efficacy of selective anticoagulation using TEG in risk stratification was comparable to that of conventional anticoagulation. Furthermore, the safety of selective anticoagulant prophylaxis was superior to that of conventional anticoagulant prophylaxis.

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Section: Introductionmentioning

confidence: 99%

The application of thromboelastography in risk stratification for selective thromboembolism prophylaxis after total joint arthroplasty in Chinese: a randomized controlled trial

Chen¹,

Ma²,

Li³

et al. 2020

Ann Palliat Med

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“…It also allows for quantitatively determining whether the body environment has a hypercoagulable state, low coagulation, fibrinolysis, or other symptoms. Based on the scope of TEG parameters, personalized approaches to guide antithrombotic therapies could be determined [23][24][25]. Our TEG results revealed that the level of TEG-R was prominently decreased and levels of TEG-MA, TEG-CI, and TEG-α were significantly increased, indicating that the activation of plasma clotting factors and platelet function might account for the enhanced coagulation in cirrhosis with PVT.…”

mentioning

confidence: 89%

A Preclinical Porcine Model of Portal Vein Thrombosis in Liver Cirrhosis

Zhang

Jiang

et al. 2020

BioMed Research International

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Background. This study aimed at presenting a novel method of developing a porcine model of portal vein thrombosis (PVT) in cirrhosis by intravenous administration of thrombin and insertion of a fibered coil. We further investigated changes of biochemical parameters, coagulation, and proinflammatory cytokine expression in the cirrhosis-PVT group. Methods. Twelve male pigs were randomized into the control group (n=3) and cirrhosis group (n=9). In cirrhotic pigs, three were randomly selected to establish PVT by ultrasound-guided percutaneous puncture of the main portal vein (MPV) followed by intravenous thrombin administration and fibered coil insertion. Thrombosis in the MPV was detected by abdominal enhanced computer tomography (CT). The changes of hepatic function, coagulation system, and inflammation cytokines were compared among normal, cirrhosis, and cirrhosis with PVT groups. Results. As manifested by the presence of a filling defect in MPV on portal venous-phase CT angiography, fibrin thrombi were formed in the MPV in cirrhotic pigs within one week and persisted for four weeks. Five weeks after surgery, abnormal liver functions occurred in association with PVT formation in cirrhosis. Both coagulation and thromboelastography parameters showed that cirrhosis-PVT pigs exhibited a procoagulant state through hyperfunction of platelets and clotting factors. Interleukin 6 (IL-6) as a potential inflammatory marker stimulated PVT-mediated inflammation activation in cirrhosis. Conclusions. Our study provides in vivo evidence that intravenous injection of a coil and thrombin into MPV under interventional guided devices enables a feasible method in thrombus creation. Further exploration and validation of large-sample cases are required to characterize utilities of this model.

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“…It can quickly determine low coagulation, hypercoagulation or solidification to fibrinolysis (involving prothrombin, thrombin, fibrin formation, stability and elasticity of blood clot) in the patient's blood directly. TEG involves the Estimated Percentage of Lysis (EPL) or Lysis at 30 min (LY30) [222]. TEG and ROTEM analysers evaluate the actual properties of a clot by the use of an immobile cylindrical cup holding the citrated whole blood and calcium chloride with specific activators and oscillating at an angle of 4 • -45 • .…”

Section: In Vitro Fibrinolytic Assaysmentioning

confidence: 99%

“…When these clots are broken down during lysis the cup motion is reduced. The rotational motion of the pin is transformed by an automatic electrical transducer to an electrical signal leading to a graphical display (plot showing viscoelastic properties of the clot over time) which is supervised by a computer [221,222]. The third alternative 'sonoclot' measures the change in resistivity to the movement on a small probe pulsating at an ultrasonic frequency in a coagulating blood sample.…”

Section: In Vitro Fibrinolytic Assaysmentioning

confidence: 99%

Microbial Fibrinolytic Enzymes as Anti-Thrombotics: Production, Characterisation and Prodigious Biopharmaceutical Applications

2021

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Cardiac disorders such as acute myocardial infarction, embolism and stroke are primarily attributed to excessive fibrin accumulation in the blood vessels, usually consequential in thrombosis. Numerous methodologies including the use of anti-coagulants, anti-platelet drugs, surgical operations and fibrinolytic enzymes are employed for the dissolution of fibrin clots and hence ameliorate thrombosis. Microbial fibrinolytic enzymes have attracted much more attention in the management of cardiovascular disorders than typical anti-thrombotic strategies because of the undesirable after-effects and high expense of the latter. Fibrinolytic enzymes such as plasminogen activators and plasmin-like proteins hydrolyse thrombi with high efficacy with no significant after-effects and can be cost effectively produced on a large scale with a short generation time. However, the hunt for novel fibrinolytic enzymes necessitates complex purification stages, physiochemical and structural-functional attributes, which provide an insight into their mechanism of action. Besides, strain improvement and molecular technologies such as cloning, overexpression and the construction of genetically modified strains for the enhanced production of fibrinolytic enzymes significantly improve their thrombolytic potential. In addition, the unconventional applicability of some fibrinolytic enzymes paves their way for protein hydrolysis in addition to fibrin/thrombi, blood pressure regulation, anti-microbials, detergent additives for blood stain removal, preventing dental caries, anti-inflammatory and mucolytic expectorant agents. Therefore, this review article encompasses the production, biochemical/structure-function properties, thrombolytic potential and other surplus applications of microbial fibrinolytic enzymes.

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Blood clot parameters: Prejudgment of fibrinolysis in thromboelastography

Cited by 7 publications

References 17 publications

The application of thromboelastography in risk stratification for selective thromboembolism prophylaxis after total joint arthroplasty in Chinese: a randomized controlled trial

The application of thromboelastography in risk stratification for selective thromboembolism prophylaxis after total joint arthroplasty in Chinese: a randomized controlled trial

A Preclinical Porcine Model of Portal Vein Thrombosis in Liver Cirrhosis

Microbial Fibrinolytic Enzymes as Anti-Thrombotics: Production, Characterisation and Prodigious Biopharmaceutical Applications

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