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Experimental and Imaging Techniques for Examining Fibrin Clot Structures in Normal and Diseased States
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Clot structure and fibrinolytic potential in patients with post thrombotic syndrome

A C Bouman1, H McPherson2, Y W Cheung3

  • 1Laboratory for Thrombosis and Hemostasis, Maastricht University Medical Centre, Maastricht, The Netherlands.

Thrombosis Research
|November 22, 2015
PubMed

Insights

Patients with post-thrombotic syndrome (PTS) have abnormal blood clot structures, characterized by thinner, denser fibrin fibers. This altered clot composition may increase the risk of future thrombosis, independent of fibrinogen levels.

Area of Science:

  • Hematology
  • Vascular Biology
  • Thrombosis Research

Background:

  • Post-thrombotic syndrome (PTS) is a chronic complication following deep vein thrombosis (DVT).
  • The specific clot structure and fibrinolytic capacity in PTS patients remain largely uncharacterized.
  • Understanding these factors is crucial for managing DVT sequelae.

Purpose of the Study:

  • To investigate the fibrinolytic potential and detailed clot structure in patients diagnosed with PTS.
  • To compare clot characteristics between PTS patients, DVT patients without PTS, and healthy individuals.
  • To explore the relationship between clot structure and recurrent venous thromboembolism (VTE).

Main Methods:

  • A case-control study design involving three groups: PTS patients (n=30), DVT controls (n=30), and healthy individuals (n=30).
  • Assessment of fibrinolysis and clot structure using turbidimetric assays, permeation studies, and confocal microscopy.
  • Quantification of fibrinogen levels via Clauss assay and fibrinogen γ' using ELISA.

Main Results:

  • A significant decrease in maximum turbidity was observed from healthy individuals to controls, and further to PTS cases, indicating denser clots.
  • Lower fibrinogen levels were found in DVT patients (cases and controls) compared to healthy individuals.
  • Patients with recurrent VTE exhibited lower maximum turbidity and reduced clot permeation compared to those with a single VTE event, even at similar fibrinogen concentrations.

Conclusions:

  • Patients with PTS and recurrent VTE tend to form clots with thinner, denser fibrin fibers, as evidenced by reduced maximum turbidity.
  • These observed differences in clot structure are not explained by variations in fibrinogen levels.
  • The abnormal clot structure identified in PTS patients may be a contributing factor to their elevated thrombotic risk profile.
Abstract

Keywords:
Clot structureDeep vein thrombosisFibrinolysisPost thrombotic syndrome

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