Fibrinogen Level and Bleeding Risk During Catheter-Directed Thrombolysis Using Tissue Plasminogen Activator

Lee, Kevin MD
Istl, Alexandra BSc
Dubois, Luc MD, MSc
DeRose, Guy MD
Forbes, Thomas L. MD
Wiseman, Daniele MD
Mujoomdar, Amol MD
Kribs, Stewart MD
Power, Adam H. MD, MPhil

¹Division of Vascular Surgery, London Health Sciences Centre, Western University, London, Ontario, Canada
²Division of Interventional Radiology, London Health Sciences Centre, Western University, London, Ontario, Canada

Corresponding Author: Adam H. Power, Division of Vascular Surgery, London Health Sciences Centre, Western University, 800 Commissioners Road East, E2–121, London, Ontario, Canada N6A5W9. Email: [email protected]

Reprints and permission: sagepub.com/journalsPermissions.nav

Vascular and Endovascular Surgery 49(7):p 175-179, October 2015. | DOI: 10.1177/1538574415611234

Abstract

Purpose:

The purpose of this study was to determine whether low fibrinogen levels (fibrinogen level <1.5 g/L) during catheterdirected 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.