Fibrinogen Level and Bleeding Risk During Catheter-Directed Thrombolysis Using Tissue Plasminogen Activator. (October 2015)

• Record Type: Journal Article
• Authors: Lee, Kevin; Istl, Alexandra; Dubois, Luc; DeRose, Guy; Forbes, Thomas L.; Wiseman, Daniele; Mujoomdar, Amol; Kribs, Stewart; Power, Adam H.
• Is Part Of: Vascular & endovascular surgery. Volume 49:Number 7(2015)
• Page Start: 175
• Page End: 179
• Publication Date: 2015-10
• Subjects: thrombolysis -- fibrinogen -- venous thrombosis -- arterial thrombosis -- bleeding risk; Blood-vessels -- Surgery -- Periodicals; Blood-vessels -- Endoscopic surgery -- Periodicals; Vascular Surgical Procedures -- Periodicals; Angioplasty -- Periodicals; Surgical Procedures, Minimally Invasive -- Periodicals; Vascular Diseases -- surgery -- Periodicals; Vaisseaux sanguins -- Chirurgie -- Périodiques; Vaisseaux sanguins -- Chirurgie endoscopique -- Périodiques; 617.41
• DOI: 10.1177/1538574415611234
• Languages: English
• ISSNs: 1538-5744

Abstract

Purpose: The purpose of this study was to determine whether low fibrinogen levels (fibrinogen level <1.5 g/L) during catheter-directed thrombolysis are associated with an increased bleeding risk. Methods: A retrospective review was performed on patients undergoing extremity arterial or venous thrombolysis between 2005 and 2013. Results: Patients in the low fibrinogen group were younger ( P = .006) and had a higher number of venous occlusive events ( P = .004). The low fibrinogen group received a larger dose of tissue plasminogen activator (tPA; P = .009) and had a longer duration of thrombolysis ( P = .010). The rates of major bleeding were not significantly different ( P = .139). Univariate analysis showed that larger total dose and longer duration of tPA infusion were associated with increased bleeding complications ( P < .01 and P = .03). Conclusion: A fibrinogen level <1.5 g/L during thrombolysis was not associated with an increased bleeding risk. However, larger dose and longer duration of thrombolysis were associated with increased bleeding risk.