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Coagulation, fibrinolysis, and platelet activation in patients undergoing open and endovascular repair of abdominal aortic aneurysm
- Source :
- Journal of Vascular Surgery. 54(3):865-878
- Publication Year :
- 2011
- Publisher :
- Elsevier BV, 2011.
-
Abstract
- Background Endovascular aneurysm repair (EVAR) is associated with an improved perioperative mortality compared to open surgical repair. This benefit may reflect reduced incidence of microvascular and macrovascular thrombotic complications after EVAR. Purpose The purpose of this study was to review and compare the effects of abdominal aortic aneurysm (AAA), open surgical repair, and EVAR on coagulation, fibrinolysis, and platelet activation. Methods A MEDLINE (1966-2010) and Cochrane library search for articles relating to the effects of AAA, open surgical repair, and EVAR on hemostasis was performed utilizing and cross-linking terms such as clotting, fibrinolysis, AAA, EVAR, and open surgical repair. Studies with a small cohort of patients (less than 7) or in which values of assessed biomarkers were not included were rejected. Results AAA is associated with increased thrombin generation, activity, and fibrin turnover as evidenced by increased plasma levels of thrombin-antithrombin III-complex (TAT), activated protein C-protein C inhibitor (APC-PCI), fibrin-monomer-fibrinogen (FM-F), F1+2, fibrinogen, and D-dimer. The extent of hemostatic derangement correlates with the volume of intraluminal thrombus. This procoagulant state is exaggerated in the immediate perioperative period after both open surgical repair and EVAR, but is attenuated at medium-term follow-up although not normalized. Conclusion The resultant prothrombotic diathesis after open surgical repair and EVAR may account for the high level of perioperative thrombotic complications.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Endovascular aneurysm repair
Risk Assessment
Aortic aneurysm
Blood Vessel Prosthesis Implantation
Risk Factors
Internal medicine
Fibrinolysis
medicine
Animals
Humans
cardiovascular diseases
Platelet activation
Blood Coagulation
Surgical repair
business.industry
Endovascular Procedures
Thrombosis
Perioperative
medicine.disease
Platelet Activation
Abdominal aortic aneurysm
Surgery
Treatment Outcome
Hemostasis
Cardiology
Female
business
Cardiology and Cardiovascular Medicine
Biomarkers
Aortic Aneurysm, Abdominal
Subjects
Details
- ISSN :
- 07415214
- Volume :
- 54
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of Vascular Surgery
- Accession number :
- edsair.doi.dedup.....ed159391a77741c57b07fc040bcf1dcc
- Full Text :
- https://doi.org/10.1016/j.jvs.2011.04.010