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The plasma D-dimer trends and their value in acute lower limb ischemia patients treated by catheter directed

Xiaochun Liu1, Hailiang Xie1, Guofu Zheng1

  • 1The Department of General Surgery, Ganzhou People's Hospital, Ganzhou, 341000, Jiangxi, People's Republic of China.

Scientific Reports
|May 18, 2021
PubMed

Insights

Plasma D-dimer levels change predictably during catheter-directed thrombolysis (CDT) for acute lower limb ischemia (ALI). Monitoring these D-dimer trends helps predict CDT efficacy and guides treatment adjustments for better patient outcomes.

Area of Science:

  • Vascular Surgery
  • Hematology
  • Medical Diagnostics

Background:

  • Acute lower limb ischemia (ALI) poses a significant risk of limb loss and mortality.
  • Catheter-directed thrombolysis (CDT) is a key treatment for ALI, but predicting its efficacy can be challenging.
  • Plasma D-dimer is a biomarker associated with thrombosis, but its dynamic changes during CDT require further investigation.

Purpose of the Study:

  • To analyze the temporal trends of plasma D-dimer in patients undergoing CDT for ALI.
  • To evaluate the clinical utility of D-dimer change trends in predicting CDT efficacy.
  • To correlate D-dimer dynamics with different treatment outcomes.

Main Methods:

  • Retrospective review of 150 ALI patients treated with CDT.
  • Analysis of repeated plasma D-dimer measurements using generalized estimating equations (GEEs).
  • Spline regression approach to visualize and analyze D-dimer change trends over time.

Main Results:

  • Plasma D-dimer levels showed significant changes over time during CDT (P < 0.001).
  • Distinct D-dimer levels and trends were observed between groups with varying CDT outcomes (ineffective, effective, markedly effective) (P < 0.001).
  • Spline regression curves clearly illustrated the differential D-dimer trends correlating with treatment success (P < 0.001).

Conclusions:

  • Plasma D-dimer exhibits regular and predictable changes during CDT for ALI.
  • Monitoring the trend of plasma D-dimer can aid in predicting CDT effectiveness.
  • D-dimer trend analysis provides valuable guidance for adjusting therapeutic regimens in ALI patients undergoing CDT.

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