title: Dimerized plasmin fragment D as a potential biomarker to predict successful catheter-directed thrombolysis therapy in acute deep vein thrombosis.
abstract: OBJECTIVE
  The value of dimerized plasmin fragment D in the clinical monitoring during the catheter-directed thrombolysis in patients with acute deep vein thrombosis is not known.
  
  
  METHODS
  Dimerized plasmin fragment D levels in 24 patients with acute deep vein thrombosis undergoing catheter-directed thrombolysis were prospectively evaluated. The plasma dimerized plasmin fragment D level was measured serially before and at every 12 h during catheter-directed thrombolysis for 24 h. Technical success was defined as restoration of patency and flow with less than 50% residual thrombus by surveillance rotational venography.
  
  
  RESULTS
  Technical success was achieved in 79.2% (19 of 24) of the treated limbs after catheter-directed thrombolysis. In univariate analysis, there was significant elevation of the dimerized plasmin fragment D at 12th h after starting the catheter-directed thrombolysis (P < 0.05) in patients with less than 50% residual thrombus stenosis. The optimal cut-off value of dimerized plasmin fragment D to predict successful catheter-directed thrombolysis was determined as 18.4 µg/ml at the 12th h after starting the catheter-directed thrombolysis with sensitivity 0.8 and specificity 0.8 (P = 0.03). It was further validated in multivariate logistic regression analysis (odds ratio: 14.38; 95% CI: 1.22-169.20; P = 0.03).
  
  
  CONCLUSIONS
  Catheter-directed thrombolysis is safe and effective for restoration of blood flow in patients with acute deep vein thrombosis. Dimerized plasmin fragment D value greater than 18.4 µg/ml at the 12th h after starting catheter-directed thrombolysis had a high predictive rate of greater than 50% lysis at the end of catheter-directed thrombolysis.
authors.affiliation: Cardiovascular Surgical Division, Department of Surgery, National Taiwan University Hospital, Taiwan.
authors.forename: Chien-Ming
authors.initials: CM
authors.lastname: Luo
authors.affiliation: Cardiovascular Surgical Division, Department of Surgery, National Taiwan University Hospital, Taiwan aaronihuiwu@gmail.com.
authors.forename: I-Hui
authors.initials: IH
authors.lastname: Wu
authors.affiliation: Cardiovascular Surgical Division, Department of Surgery, National Taiwan University Hospital, Taiwan.
authors.forename: Chih-Yang
authors.initials: CY
authors.lastname: Chan
authors.affiliation: Cardiovascular Surgical Division, Department of Surgery, National Taiwan University Hospital, Taiwan.
authors.forename: Yih-Sharng
authors.initials: YS
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taiwan.
authors.forename: Wei-Shiung
authors.initials: WS
authors.lastname: Yang
authors.affiliation: Cardiovascular Surgical Division, Department of Surgery, National Taiwan University Hospital, Taiwan.
authors.forename: Shoei-Shen
authors.initials: SS
authors.lastname: Wang
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D002404:Catheterization; D019281:Dimerization; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000737:chemistry*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010690:Phlebography; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis; D018608:Ultrasonography, Doppler; D020246:Venous Thrombosis / Q000628:therapy*
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; C015214:fibrinogen D fragment
keywords: Deep vein thrombosis; fibrin fragment D; fibrinolytic therapy; percutaneous transluminal angioplasty; peripheral venous catheterization