Coagulation and fibrinolysis after open infrarenal abdominal aortic aneurysm repair in a long-term perspective

In patients with abdominal aortic aneurysms (AAA) the coagulation and fibri nolytic systems have been found to be activated preoperatively, Does the in creased activity of the coagulation and fibrinolytic systems persist after AAA surgery in a long-term perspective? Prothrombin fragment 1+2 (F1+2), th rombin-antithrombin complex (TAT), tissue plasminogen activator (tPA), huma n plasminogen activator inhibitor type 1, and human cross-linked fibrin deg radation product (D-dimer) were analysed in is patients after open AAA surg ery (postop-AAA). The median time between surgery and blood sampling was 19 months (range, 5-37 months). Comparisons were made with both preoperative values of 23 patients with AAA (preop-AAA) as well as 20 age-matched health y controls (AMC), F1+2, TAT, and D-dimer in preop-AAA were significantly hi gher compared to AMC p<0.001). In post-op AAA patients these parameters wer e significantly lower compared to preop-AAA (p<0.05 for F1+2 and TAT, p<0.0 01 for D-dimer). However, TAT and D-dimer levels were still higher in posto p-AAA than in AMC (p<0.01 for both). The activity of the coagulation and fi brinolytic systems seems to decrease after AAA surgery. However, the activi ty is still higher than in healthy AMC. A possible explanation may be that the thrombogenicity is lower in a vascular graft than in an aneurysmal sac but still higher than in a nonaneurysmal aorta. (C) 1999 Elsevier Science L td. All rights reserved.