Document Detail


Rebound increase of PAI-1 following local intra-arterial rt-PA infusion, a possible cause of reocclusion.
MedLine Citation:
PMID:  8218853     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We studied systemic changes in the plasminogen activating system induced by local intra-arterial infusion of recombinant t-PA (rt-PA) in ten patients with arterial occlusion. The arterial infusion of rt-PA resulted in an immediate increase of t-PA activity and antigen in venous plasma. Concomitantly the plasma was depleted of PAI-1 activity with a moderate decrease of PAI-1 antigen, presumably due to immediate complexing of rt-PA by PAI-1 and gradual elimination of the rt-PA/PAI-1 complex from the circulation. Activation of plasminogen in the circulation was reflected by the occurrence of fibrinogen/fibrin degradation products. This rapid systemic activation of the fibrinolytic system at local intra-arterial administration of rt-PA might be due to the opening of small collaterals or backward flow through open arteries, allowing rt-PA to enter the general circulation. The disappearance of detectable PAI-1 activity during rt-PA infusion was followed by a rebound effect with a significant increase of PAI-1 antigen. As this increase may have contributed to the reocclusion which occurred in four patients, it might be advisable to replace heparin by rt-PA at a lower dosage in the immediate phase following rt-PA infusion.
Authors:
B Astedt; B Casslén; I Lecander; L Nilsson; L Norgren
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis     Volume:  4     ISSN:  0957-5235     ISO Abbreviation:  Blood Coagul. Fibrinolysis     Publication Date:  1993 Aug 
Date Detail:
Created Date:  1993-12-01     Completed Date:  1993-12-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9102551     Medline TA:  Blood Coagul Fibrinolysis     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  563-7     Citation Subset:  IM    
Affiliation:
Department of Gynaecology and Obstetrics, University of Lund, University Hospital, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Arterial Occlusive Diseases / drug therapy*,  etiology
Female
Humans
Infusions, Intra-Arterial
Male
Middle Aged
Plasminogen Activator Inhibitor 1 / metabolism*
Recombinant Proteins / administration & dosage
Recurrence
Tissue Plasminogen Activator / administration & dosage*
Chemical
Reg. No./Substance:
0/Plasminogen Activator Inhibitor 1; 0/Recombinant Proteins; EC 3.4.21.68/Tissue Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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