title: Fibrinogen Level and Bleeding Risk During Catheter-Directed Thrombolysis Using Tissue Plasminogen Activator.
abstract: OBJECTIVE
  The purpose of this study was to determine whether low fibrinogen levels (fibrinogen level <1.5 g/L) during catheter-directed thrombolysis are associated with an increased bleeding risk.
  
  
  METHODS
  A retrospective review was performed on patients undergoing extremity arterial or venous thrombolysis between 2005 and 2013.
  
  
  RESULTS
  Patients in the low fibrinogen group were younger (P = .006) and had a higher number of venous occlusive events (P = .004). The low fibrinogen group received a larger dose of tissue plasminogen activator (tPA; P = .009) and had a longer duration of thrombolysis (P = .010). The rates of major bleeding were not significantly different (P = .139). Univariate analysis showed that larger total dose and longer duration of tPA infusion were associated with increased bleeding complications (P < .01 and P = .03).
  
  
  CONCLUSIONS
  A fibrinogen level <1.5 g/L during thrombolysis was not associated with an increased bleeding risk. However, larger dose and longer duration of thrombolysis were associated with increased bleeding risk.
authors.affiliation: Division of Vascular Surgery, London Health Sciences Centre, Western University, London, Ontario, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Lee
authors.affiliation: Division of Vascular Surgery, London Health Sciences Centre, Western University, London, Ontario, Canada.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Istl
authors.affiliation: Division of Vascular Surgery, London Health Sciences Centre, Western University, London, Ontario, Canada.
authors.forename: Luc
authors.initials: L
authors.lastname: Dubois
authors.affiliation: Division of Vascular Surgery, London Health Sciences Centre, Western University, London, Ontario, Canada.
authors.forename: Guy
authors.initials: G
authors.lastname: DeRose
authors.affiliation: Division of Vascular Surgery, London Health Sciences Centre, Western University, London, Ontario, Canada.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Forbes
authors.affiliation: Division of Interventional Radiology, London Health Sciences Centre, Western University, London, Ontario, Canada.
authors.forename: Daniele
authors.initials: D
authors.lastname: Wiseman
authors.affiliation: Division of Interventional Radiology, London Health Sciences Centre, Western University, London, Ontario, Canada.
authors.forename: Amol
authors.initials: A
authors.lastname: Mujoomdar
authors.affiliation: Division of Interventional Radiology, London Health Sciences Centre, Western University, London, Ontario, Canada.
authors.forename: Stewart
authors.initials: S
authors.lastname: Kribs
authors.affiliation: Division of Vascular Surgery, London Health Sciences Centre, Western University, London, Ontario, Canada adam.power@lhsc.on.ca.
authors.forename: Adam H
authors.initials: AH
authors.lastname: Power
mesh_terms: D001157:Arterial Occlusive Diseases / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D015415:Biomarkers / Q000097:blood; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D015536:Down-Regulation; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D006470:Hemorrhage / Q000097:blood / Q000139:chemically induced*; D006801:Humans; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D008297:Male; D011677:Punctures / Q000009:adverse effects; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D013927:Thrombosis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D015415:Biomarkers; D005343:Fibrinolytic Agents; D005340:Fibrinogen; D010959:Tissue Plasminogen Activator
keywords: arterial thrombosis; bleeding risk; fibrinogen; thrombolysis; venous thrombosis