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Changes in the fibrinolytic system in patients with peripheral arterial occlusive disease undergoing percutaneous

R E Roller1, S Janisch, V Carroll

  • 1Department of Vascular Biology and Thrombosis Research, University of Vienna, Austria.

Thrombosis Research
|May 21, 1999
PubMed

Insights

Peripheral arterial occlusive disease (PAOD) patients show impaired fibrinolysis after angioplasty, with higher PAI-1 activity linked to restenosis. This suggests fibrinolysis plays a role in vascular repair after PTA.

Area of Science:

  • Vascular Biology
  • Hemostasis and Thrombosis
  • Interventional Cardiology

Background:

  • Peripheral arterial occlusive disease (PAOD) is characterized by impaired blood flow in the limbs.
  • Percutaneous transluminal angioplasty (PTA) is a common intervention for PAOD.
  • Fibrinolysis, the breakdown of blood clots, plays a crucial role in vascular health and repair.

Purpose of the Study:

  • To investigate fibrinolytic parameters in PAOD patients before and after PTA.
  • To compare fibrinolytic profiles between PAOD patients and healthy controls.
  • To identify potential markers for restenosis following PTA.

Main Methods:

  • Assessed fibrinolytic parameters including t-PA antigen, PAI-1 antigen and activity, PCI, and fibrinogen levels.
  • Measured these parameters in 33 PAOD patients pre-PTA and at 6, 24, and 48 hours post-PTA.
  • Compared patient data with 35 age- and gender-matched healthy controls.

Main Results:

  • PAOD patients exhibited higher baseline levels of t-PA antigen, PAI-1 antigen and activity, PCI, and fibrinogen compared to controls.
  • Fibrinolytic parameters and fibrinogen levels increased post-PTA, peaking at 24 and 48 hours.
  • Restenosis occurred in 42% of patients; those with restenosis had significantly higher PAI-1 activity 24 and 48 hours post-PTA.

Conclusions:

  • PAOD patients have altered fibrinolytic profiles, with elevated PAI-1 levels.
  • Impaired fibrinolysis post-PTA may indicate a disturbed vascular repair process.
  • Elevated PAI-1 activity after PTA could serve as a marker for late restenosis.

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