Activation of the hemostatic process in patients with unruptured aortic aneurysm before and in the first week after surgical repair.
OBJECTIVE
It has been previously suggested that activation of coagulation and fibrinolysis may sometime occur in patients with unruptured aortic aneurysm. However, the incidence of this complication and the effect of surgical repair are unknown. The objective of our study was to gain further information on this topic.


METHODS
We investigated activation of the hemostatic process in 20 consecutive patients with unruptured abdominal aortic aneurysm. We then evaluated the effect of surgical repair of the vascular abnormalities.


RESULTS
Both before and in the first week after surgery, the large majority of patients showed clear signs of activation of coagulation (increased plasma levels of prothrombin fragment 1 + 2 and fibrin peptide A), and many had low levels of the natural anticoagulant antithrombin III. Platelets were activated in all cases (high levels of plasma beta-thromboglobulin), and signs of platelet consumption (thrombocytopenia and/or increased mean platelet volume) were present in most of them.


CONCLUSIONS
Activation of the hemostatic process occurs in nearly all patients with abdominal aortic aneurysm and could play a role in the hemorrhagic and thrombotic events that can complicate the clinical development of these subjects.
Balduini
C L
CL
Institute of Internal Medicine-Medical Oncology, University of Pavia-IRCCS S. Matteo, Italy.
Salvini
M
M
Montani
N
N
Noris
P
P
Spedini
P
P
Belletti
S
S
Gamba
G
G
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D006487:Hemostasis; D006801:Humans; D008297:Male; D010974:Platelet Aggregation; D011184:Postoperative Period; D011446:Prospective Studies; D013917:Thrombin / Q000378:metabolism
D013917:Thrombin