Efficacy of Catheter-directed Thrombolysis on Post-burn Deep Venous Thrombosis of Lower Extremity

Gao, Guozheng; Zhu, Shugang; Xie, Zhen; Wang, Jiasen; Baohong, Yao

doi:10.29271/jcpsp.2019.05.448

Cited by 3 publications

(3 citation statements)

References 17 publications

(17 reference statements)

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“…Urokinase is a commonly used thrombolytic drug in CDT; 8,[19][20][21][22][23] it can catalyze plasminogen into plasmin, and plasmin can cleave fibrin to D-D. The concentration of D-D in plasma is increased in patients with acute venous thromboembolism (VTE).…”

Section: Discussionmentioning

confidence: 99%

A new method of monitoring catheter-directed thrombolysis for deep venous thrombosis—application of D-dimer and fibrinogen testing

et al. 2022

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Background Catheter-directed thrombolysis (CDT) is one of the main treatment methods for acute deep venous thrombosis (DVT), which has the characteristics of long treatment time and large dosage of thrombolytic drugs. In the absence of good monitoring methods, problems such as low thrombolytic efficiency and high risk of bleeding are easy to occur. Objective To evaluate the value of D-dimer (D-D) and fibrinogen (FIB) testing as a thrombolysis-monitoring method during CDT for acute DVT. Methods Twenty patients with acute DVT were divided into group A and group B. During CDT, the D-D and FIB testing every 8 h were used in group A, and the venography and FIB testing every 24 h in group B. The thrombolysis rate, thrombolysis time, urokinase dosage, and X-ray radiation dose were compared. Results The thrombolysis rate in group A was significantly higher than that in group B ( p < 0.05), but the number of venography and radiation dose were significantly lower than those in group B ( p < 0.05). Conclusion D-D and FIB testing can improve the thrombolysis rate, reduce the risk of bleeding, and decrease the number of angiograms and X-ray radiation dose during CDT.

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Section: Discussionmentioning

confidence: 99%

A new method of monitoring catheter-directed thrombolysis for deep venous thrombosis—application of D-dimer and fibrinogen testing

et al. 2022

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“…Urokinase is a commonly used drug in thrombolytic therapy. 1,[14][15][16][17] It can catalyze plasminogen into plasmin, and plasmin can cleave fibrin (the major structure in the thrombus) to D-D. D-D is the final product of the plasminmediated degradation of crosslinked fibrin. 5 The concentration of D-D in plasma increases in patients with acute VTE.…”

Section: Discussionmentioning

confidence: 99%

The role of D-dimer and fibrinogen testing in catheter-directed thrombolysis with urokinase for deep venous thrombosis

et al. 2023

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Background During catheter-directed thrombolysis (CDT), D-dimer (D-D) are generated in large quantities and fibrinogen (FIB) is continuously consumed. Reduction of FIB increases the risk of bleeding. However, there are currently few studies on the relationship between D-D and FIB concentrations during CDT. Objectives To evaluate the relationship of D-D and FIB concentrations during CDT with urokinase for deep venous thrombosis (DVT). Method 17 patients with lower limb DVT were enrolled and treated with CDT. The concentrations of plasma D-D and FIB were measured every 8 h during thrombolysis. The degree of thrombolysis was evaluated, the change rules of D-D and FIB concentrations were analyzed, and the change curve graphs were drawn. The “thrombus volume,” “thrombolysis time,” “thrombolysis ratio,” “D-D peak,” “D-D rising speed,” “FIB falling speed,” and “duration of D-D elevation” were calculated in each patient. The mixed model was used to simulate the time change trend of the plasma D-D and FIB concentrations. Pearson method and linear regression were used to analyze the correlation and linear relationship, respectively. Results The D-D concentration first increased rapidly and then decreased gradually, and the FIB concentration continued to decrease during thrombolysis. The rate of the decline of FIB varies with the urokinase dose. The thrombus volume is positively correlated with D-D rising speed, duration of D-D elevation, D-D peak, and FIB falling speed; the D-D rising speed is positively correlated with the D-D peak and FIB falling speed; and the D-D peak is positively correlated with the FIB falling speed. The correlation coefficients were all statistically significant ( p < 0.05). Efficacy reached level I–II in 76.5% patients. No major bleeding occurred in any of the patients. Conclusion During CDT with urokinase for DVT, the concentrations of D-D and FIB show specific changes, and there are some specific relationships between each other. Understanding these changes and relationships may be helpful to adjust the thrombolysis time and urokinase dose more rationally.

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“…Its level is commonly used in the clinical diagnosis and treatment evaluation of venous thromboembolic (VTE) 8 . Thrombolytic efficacy can be evaluated by monitoring plasma D-dimer levels during CDT in patients with deep vein thrombosis 9 , 10 . Before and after thrombolysis, the changes in plasma D-dimer levels are also considered to be significantly correlated with coronary recanalization, which could be used to predict the thrombolysis efficacy after acute myocardial infarction 6 , 7 .…”

Section: Introductionmentioning

confidence: 99%

The plasma D-dimer trends and their value in acute lower limb ischemia patients treated by catheter directed thrombolysis

Liu

Xie

Zheng

et al. 2021

Sci Rep

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To investigate the change trends of plasma D-dimer during catheter-directed thrombolysis (CDT) in acute lower limb ischemia (ALI) patients and their clinical value. A retrospective review of patients with ALI who received CDT was carried out. The repeated measurements of plasma D-dimer were analyzed by generalized estimating equations (GEEs) and the change trends of D-dimer were analyzed by spline regression approach. A total of 150 patients were included. Among them, 3 days of CDT was ineffective in 41 cases, effective in 33 cases and markedly effective in 76 cases. The results of GEEs analysis showed that serum D-dimer changed significantly with time (time effect, P < 0.001). Serum D-dimer levels of patients with different treatment outcomes were different after treatment (group effect, P < 0.001), and serum D-dimer levels in these three groups showed different trends over time (group*time effect, P < 0.001). The different trends in serum D-dimer level with time after treatment in the three groups could be directly seen in the spline regression curve (P < 0.001). The plasma D-dimer changes regularly during CDT for ALI. We can predict the efficacy of CDT and guide adjustments of the therapeutic regimen according to the trend of D-dimer changes during thrombolysis.

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Efficacy of Catheter-directed Thrombolysis on Post-burn Deep Venous Thrombosis of Lower Extremity

Abstract: Objective: To observe the clinical effect of catheter-directed thrombolysis on deep venous thrombosis (DVT) of lower extremity after burn.

Cited by 3 publications

References 17 publications

A new method of monitoring catheter-directed thrombolysis for deep venous thrombosis—application of D-dimer and fibrinogen testing

A new method of monitoring catheter-directed thrombolysis for deep venous thrombosis—application of D-dimer and fibrinogen testing

The role of D-dimer and fibrinogen testing in catheter-directed thrombolysis with urokinase for deep venous thrombosis

The plasma D-dimer trends and their value in acute lower limb ischemia patients treated by catheter directed thrombolysis

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