Soluble, thrombin-related material in arterial thrombi and plasma studied during catheter-directed intra-arterial thrombolysis.
We investigated soluble, thrombin-related material in arterial thrombi and venous plasma during catheter-directed thrombolysis with alteplase. Arteriography was performed before thrombolysis and 0.5, 3, 10 and 24 h after the onset of treatment in six patients with (sub)acute lower extremity ischaemia caused by native artery or bypass occlusion. Samples were collected simultaneously from the thrombus and venous blood. After adding inhibitors of thrombin and plasmin, the centrifuged samples were assayed for prothrombin fragment 1+2 (F1+2), thrombin-antithrombin complex (TAT) and fibrinopeptide A (FPA). Levels of F1+2, TAT and FPA were extremely elevated in the thrombus-related samples before the blood flow was re-established (at 0 and 0.5 h) in all five successfully treated patients. In comparison, venous plasma levels of F1+2, TAT and FPA were moderately elevated, and reached a maximum at 3 h. In conclusion, material aspirated from lysing human thrombi formed in vivo contains large amounts of F1+2, TAT and FPA, but our methods prevented us from detecting enzymatically active thrombin.
Sandbaek
G
G
Research Institute for Internal Medicine, Rikshospitalet, The National Hospital, University of Oslo, Norway. gunnar.sandbaek@rh.uio.no
Bjørnsen
S
S
Brosstad
F
F
D000368:Aged; D000792:Angiography; D000990:Antithrombin III / Q000032:analysis*; D001779:Blood Coagulation Factors / Q000032:analysis*; D002404:Catheterization; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005344:Fibrinopeptide A / Q000032:analysis; D006801:Humans; D007511:Ischemia / Q000188:drug therapy; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000032:analysis; D010447:Peptide Hydrolases / Q000032:analysis*; D011498:Protein Precursors / Q000032:analysis; D011516:Prothrombin / Q000032:analysis; D012995:Solubility; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000097:blood* / Q000188:drug therapy*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome
D001779:Blood Coagulation Factors; D005343:Fibrinolytic Agents; D010446:Peptide Fragments; D011498:Protein Precursors; C046193:antithrombin III-protease complex; D005344:Fibrinopeptide A; C029733:prothrombin fragment 1; C044183:prothrombin fragment 2; D000990:Antithrombin III; D011516:Prothrombin; D010447:Peptide Hydrolases; D010959:Tissue Plasminogen Activator