[Effects on blood coagulation-fibrinolytic system after transcatheter hepatic arterial therapy in cases of hepatocellular carcinoma analyzed by plasma levels of plasmin-alpha 2-PI complex, D dimer and thrombin-ATIII complex].
To clarify the effects on blood coagulation-fibrinolytic system after transcatheter hepatic arterial therapy for cases of hepatocellular carcinoma (HCC), plasma levels of Plasmin-alpha 2PI complex (PIC), Ddimer and Thrombin-ATIII (TAT) before and after therapy were measured by EIA, in addition to other conventional coagulofibrinolytic parameters. In the group (9 cases) treated with intra-arterial injection of adriamycin, there were no significant changes of coagulofibrinolytic parameters except for Ddimer (P less than 0.05) which was elevated 1-2 days after therapy. However, only two cases in whom plasma PIC, Ddimer and TAT levels were clearly elevated before therapy, showed further marked elevation of those parameters after therapy. In the group (29 cases) treated with intra-arterial injection of adriamycin-lipiodol suspension, whether or not embolized with gelfoam, plasma PIC, Ddimer and TAT levels were significantly elevated (P less than 0.01) after therapy, as well as other conventional coagulofibrinolytic parameters. These results indicate that hypercoagulable and hyperfibrinolytic states were induced by treatment. Moreover, the secondary hyperfibrinolytic state tended to persist longer than the hypercoagulable state. The 14 cases embolized with gelfoam seemed to have more apparent effects on blood coagulation-fibrinolytic system than cases not treated with gelfoam. Therefore, we conclude that caution and prophylaxis for the occurrence of disseminated intravascular coagulation are necessary for transcatheter arterial therapy for cases of HCC.
Second Department of Internal Medicine, St. Marianna University School of Medicine.
A
A
Mizuguchi
S
S
Iwabuchi
N
N
Moriyama
Y
Y
Yoshida
M
M
Takatori
A
A
Kamogawa
J
J
Sugai
D000990:Antithrombin III / Q000378:metabolism*; D001777:Blood Coagulation; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D005341:Fibrinolysin / Q000378:metabolism*; D005342:Fibrinolysis; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000628:therapy*; D010447:Peptide Hydrolases / Q000378:metabolism*; D000511:alpha-Macroglobulins / Q000378:metabolism*
D005338:Fibrin Fibrinogen Degradation Products; D000511:alpha-Macroglobulins; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; C024668:plasmin-alpha(2)-macroglobulin complex; D000990:Antithrombin III; D010447:Peptide Hydrolases; D005341:Fibrinolysin