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Fibrinolytic activity and calf pump failure.

H Gajraj1, N L Browse

  • 1Department of Surgery, United Medical School, London, UK.

The British Journal of Surgery
|August 1, 1991
PubMed
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Impaired fibrinolysis in the legs of patients with varicose veins or healed ulcers suggests reduced clot breakdown. This is linked to poor calf pump function and lower skin oxygen levels, impacting circulation.

Area of Science:

  • Vascular Biology
  • Physiology
  • Dermatology

Background:

  • Abnormal calf pump function is associated with venous diseases like varicose veins and ulcers.
  • Interstitial fibrinolytic activity plays a role in clot lysis and tissue repair.

Purpose of the Study:

  • To investigate interstitial fibrinolytic activity in the limbs of individuals with compromised calf pump function.
  • To correlate fibrin clot lysis rates with calf pump efficiency and skin nutritive circulation.

Main Methods:

  • Experimentally produced subcutaneous 125I-fibrin clots were used to measure lysis rates.
  • Calf pump function was assessed using foot volumetry.
  • Skin nutritive circulation was evaluated by measuring transcutaneous oxygen tension (PtcO2).

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Main Results:

  • Fibrin clearance was significantly prolonged in the legs of subjects with varicose veins and healed venous ulcers compared to controls.
  • A negative correlation was observed between fibrin clearance half-life and half-volume refilling time (P < 0.01).
  • Fibrin clearance half-life also negatively correlated with transcutaneous oxygen tension (P < 0.01).

Conclusions:

  • Reduced interstitial fibrinolytic activity in the lower limbs is associated with abnormal calf pump function.
  • Impaired fibrinolysis may contribute to the pathophysiology of venous insufficiency and delayed healing in conditions like varicose veins and ulcers.