HIGH F1.2 FRAGMENT OF PROTHROMBIN, THROMBIN-ANTITHROMBIN-III COMPLEX (TAT) AND SOLUBLE FIBRIN PLASMA-LEVELS DEMONSTRATE HYPERCOAGULABILITY INDUCED DURING LOCO-REGIONAL THROMBOLYTIC THERAPY WITH RT-PA

In order to investigate the coagulation and fibrinolysis state in arte rial peripheral thrombosis and thrombolysis, we studied 33 consecutive patients (mean age=65, range: 28-88), 25 males and 8 females diagnose d of acute or subacute lower limb arterial thrombosis, treated with an intrathrombus infusion of rt-PA (0.1 mg/Kg/h) for three hours. Plasma levels of antithrombin III (ATIII), protein C (PC), plasminogen (Pg) and alpha(2)-antiplasmin (AP), total and free protein S (PS), thrombin -antithrombin III complex (TAT), F1.2 fragment of prothrombin (F1.2), fibrinogen (Fg), soluble fibrin monomers (FM), tissue-plasminogen acti vator (t-PA), plasminogen activator inhibitor 1 (PAI-1), total fibrino gen/fibrin degradation products (TDP) and D dimer (DD) were determined prior to the therapeutic regime, at the end of the treatment, and 24 hours later. Levels of AT-III and protein C were somewhat low during t he complete study. There was an increase in t-PA, TDP and D Dimer and a decrease of fibrinogen, alpha,antiplasmin and plasminogen at 3 hours . An elevation of TAT, fibrin monomers and F1.2 levels was found at th ree hours. A positive correlation between TAT and F1.2 was observed (r =0.57, p<0.05). There was also a positive correlation between soluble fibrin and TAT (r=0.59, p<0.05) and with F1.2 (r=0.56. p<0.05). These latter facts reflect an hypercoagulable situation induced during loco- regional thrombolytic therapy.