Changes in circulatory indices of thrombosis and fibrinolysis during total knee arthroplasty performed under tourniquet

Deep vein thrombosis may begin during surgery with the tourniquet inflated. Arterial levels of fibrinopeptide A, thrombin—antithrombin complexes, D-dimer, tissue plasminogen activator (t-PA) activity, and t-PA antigen were measured before surgery, during surgery with the tourniquet inflated, and fol...

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Bibliographic Details
Published in:The Journal of arthroplasty 1995-08, Vol.10 (4), p.523-528
Main Authors: Sharrock, N.E., Go, G., Sculco, T.P., Ranawat, C.S., Maynard, M.J., Harpel, P.C.
Format: Article
Language:English
Subjects:
anesthetic technique
D-dimer
epidural
Fibrinolysis
fibrinopeptide A
Fibrinopeptide A - metabolism
heparin
Humans
Knee Joint
Knee Prosthesis
Osteoarthritis - surgery
Thrombophlebitis - blood
Thrombophlebitis - etiology
Thrombophlebitis - physiopathology
Tissue Plasminogen Activator - blood
total knee arthroplasty
Tourniquets
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Summary:Deep vein thrombosis may begin during surgery with the tourniquet inflated. Arterial levels of fibrinopeptide A, thrombin—antithrombin complexes, D-dimer, tissue plasminogen activator (t-PA) activity, and t-PA antigen were measured before surgery, during surgery with the tourniquet inflated, and following deflation of the tourniquet in 12 patients undergoing total knee arthroplasty. Minimal increases in fibrinopeptide A, thrombin—antithrombin complexes, and D-dimer were noted during surgery with the tourniquet inflated, but significant increases occurred immediately following deflation of the tourniquet. In 10 patients, intravenous heparin administration significantly suppressed the rise in fibrinopeptide A, but did not significantly alter the increases in either thrombin—antithrombin complexes, D-dimer, t-PA antigen, or t-PA activity. This study provides further evidence that deep vein thrombosis begins during surgery.
ISSN:0883-5403
1532-8406
DOI:10.1016/S0883-5403(05)80155-X