Plasma D-dimer Trends in Patients Undergoing Catheter-directed Thrombolysis or Anticoagulation Therapy for Deep Venous Thrombosis

Wednesday, September 20, 2023

11:06 AM – 11:16 AM US EDT

Location: Grand Ballroom A

Introduction, Objectives, and/or Purpose: Plasma D-dimer levels represent the degradation of fibrin in the body and its measurement was initially introduced into clinical practice to assist in the diagnosis of venous thromboembolism (VTE). More recently, studies have demonstrated further utility of assessing plasma D-dimer levels in multiple cardiovascular diseases to evaluate for diagnosis, response to treatment, potential prognosis, and risk of recurrence. Plasma D-dimer levels are known to be affected by thrombolytic therapy. Changes in D-dimer level, before and after thrombolytic therapy, have been shown to correlate with reperfusion in other occlusive processes such as acute limb ischemia or myocardial infarction. The purpose of our study was to evaluate the dynamics of the level of plasma D-dimer in patients undergoing catheter-directed thrombolysis (CDT) compared to patients undergoing anticoagulation therapy for deep venous thrombosis (DVT).

Methods: Eighty six (86) patients diagnosed with acute iliofemoral deep venous thrombosis (DVT) over two years in 2021-2022 had plasma D-dimer levels tested at the time of the diagnosis and during 2-7 days of therapy. Fifty (50) patients were treated with CDT and 36 were managed conservatively with anticoagulation. Basic information and comorbidities were assessed including age, BMI, gender, history of tobacco use, and history of VTE. Statistical analysis was performed using IBM SPSS Statistics (Version 27).

Results: The 50 patients treated with CDT included. 25 females (50%) and 25 males (50%) with the mean age of 54 ± 17 years. Twenty-eight of them (56%) had history of VTE,80%, had their procedure completed by hospital admission day 2. Plasma D-dimer levels demonstrated an initial increase during the first 24 hours of thrombolysis and a statistically significant decrease on day 2.

In 36 patients who were managed with anticoagulation, plasma D-dimer levels progressively decreased overtime, with a statistically significant drop from the baseline during the first two days.

Conclusion(s): Changes in plasma D-dimer levels indicate significant breakdown of fibrin during initial hours of thrombolysis, but not during anticoagulation. This study data suggest that D-dimer may be used to monitor the effectiveness of treatment in patients with iliofemoral DVT.

Presenting Author(s)

TM

Tamara Maghathe, MD

Vascular Surgery Resident
University of Toledo College of Medicine & Life Sciences, United States

Disclosure(s):
The forementioned Program Planner, Faculty, Author, Moderator, or Speaker, has declared for this educational activity, having no relevant financial relationship(s) with ineligible companies to disclose.

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Co-Author(s)

LA

Loay Abusalha, BS

Medical Student
University of Toledo College of Medicine, United States

Disclosure(s):
The forementioned Program Planner, Faculty, Author, Moderator, or Speaker, has declared for this educational activity, having no relevant financial relationship(s) with ineligible companies to disclose.
TR

Todd Russell, MD

Senior Associate Program Director ProMedica Toledo Hospital/Jobst Vascular Institute Vascular Surg
Jobst Vascular Institute / ProMedica Health System, United States

Disclosure(s):
The forementioned Program Planner, Faculty, Author, Moderator, or Speaker, has declared for this educational activity, having no relevant financial relationship(s) with ineligible companies to disclose.
GK

Gregory Kasper, MD

President and CMO of Jobst Vascular Institute
Jobst Vascular Institute / ProMedica Health System, United States

Disclosure(s):
The forementioned Program Planner, Faculty, Author, Moderator, or Speaker, has declared for this educational activity, having no relevant financial relationship(s) with ineligible companies to disclose.
PS

Patrick Sullivan, MD

Fellow
Jobst Vascular Institute
Promedica Jobst Vascular Institute
Toledo, Ohio, United States

Disclosure(s):
The forementioned Program Planner, Faculty, Author, Moderator, or Speaker, has declared for this educational activity, having no relevant financial relationship(s) with ineligible companies to disclose.
Fedor Lurie, MD, PhD (he/him/his)

UIP Research Chair
Jobst Vascular Institute
University of Michigan
Toledo, Ohio, United States

Disclosure(s): Sigvar: Speaker/Honoraria