Sustained Release of Tissue Factor Following Thrombosis of Lower Limb Trauma

This study was undertaken to provide evidence for the mechanism of venous thromboembolism (VTE) in healthy patients with minor lower limb injury (fracture; Achilles tendon rupture) that was medically managed with plaster cast/brace immobilization. The Plaster Cast clinical trial provided a unique opportunity to identify the natural history of VTE using placebo-controlled patients (n = 183) with validation of the mechanism using the low-molecular-weight heparin (LMWH; reviparin)-treated patients (n = 182). Confirmed VTE in this population was associated with a burst of tissue factor release (and a minor fibrinolytic deficit) leading to thrombin generation that was sustained at least 5 weeks, greater with fractures than with soft-tissue injuries and greater with surgery than with conservative treatment. The root cause likely involves platelet/leukocyte activation (inflammation) rather than endothelial cell injury. Thromboprophylaxis with a low dose of LMWH reduced thrombin generation, with patients undergoing surgery benefitting the most.

Source: Clinical and Applied Thrombosis/Hemostasis - August 26, 2014 Category: Hematology Authors: Walenga, J. M., Kaiser, P. C., Prechel, M. M., Hoppensteadt, D., Jeske, W. P., Misselwitz, F., Bacher, P., Lassen, M. R., Fareed, J. Tags: Original Articles Source Type: research