Abdominal Aortic Aneurysm Surgery and Thrombosis
Ключевые слова
абстрактный
Описание
Abdominal aortic aneurysm (AAA) develops in the context of atherosclerosis or infection (aortitis or mycotic aneurysm). AAA and its surgery are associated with pro-thrombotic modifications of hemostasis, which persists in the post-operative period. Pro-thrombotic reactions occur in the intraluminal thrombus. Inflammatory cells recruitment is mediated by adhesion molecules from the activated endothelium, such as "vascular cell adhesion molecule-1" (VCAM-1), "intercellular adhesion molecule-1" (ICAM-1), P-selectin and E-selectin.
In the setting of infection, neutrophil death process occurs, the NETosis, with the liberation of Neutrophil Extracellular Traps (NETs), containing DNA and histones. NETs are associated with thrombosis and various studies have already quantified NETosis biomarkers in plasma from patients with thrombotic disease, such as MPO-DNA (DNA coupled myeloperoxidase).
In the clinical perioperative setting, patients with aortitis scheduled for AAA surgery shwoed exhibit thrombotic events.
The hypothesize was that patients with aortitis have an inflammatory and hemostatic activation different from patients who develop AAA in atherosclerotic condition, and that inflammation is a risk factor of postoperative thrombotic events.
Даты
| Последняя проверка: | 02/29/2020 |
| Первый отправленный: | 03/08/2020 |
| Предполагаемая регистрация отправлена: | 03/25/2020 |
| Первое сообщение: | 03/26/2020 |
| Последнее обновление отправлено: | 03/25/2020 |
| Последнее обновление опубликовано: | 03/26/2020 |
| Фактическая дата начала исследования: | 03/05/2020 |
| Предполагаемая дата завершения начальной школы: | 12/30/2020 |
| Предполагаемая дата завершения исследования: | 04/29/2021 |
Состояние или болезнь
Фаза
Критерии приемлемости
| Возраст, имеющий право на обучение | 18 Years Чтобы 18 Years |
| Полы, имеющие право на обучение | All |
| Метод отбора проб | Non-Probability Sample |
| Принимает здоровых добровольцев | Нет |
| Критерии | Inclusion Criteria: - patient >18 years-old; - patient scheduled for AAA surgery by laparotomy in the vascular surgical unit at Bordeaux University Hospital; - patient who gave his/her authorization for the use of its medical data and results of blood analyses performed on residual plasma and results of aortic material analyses Exclusion Criteria: - patient who do not understand the study (not fluently French speaking or unable to give his/her consent); - patient with a pre-existing hemostatic disorder; - patient scheduled for an endovascular surgery and benefiting from a secondary laparotomy |
Результат
Основные показатели результатов
1. thrombotic events [first 7 postoperative days after AAA surgery]
Меры вторичного результата
1. white blood cells [baseline]
2. hemoglobin [baseline]
3. platelets [baseline]
4. prothrombin time ratio [baseline]
5. INR [baseline]
6. aPTT ratio [baseline]
7. fibrinogen [baseline]
8. CRP [baseline]
9. interleukin-6 [baseline]
10. thrombin generation test [baseline]
11. peak [baseline]
12. time to peak [baseline]
13. ETP [baseline]
14. velocity index [baseline]
15. von Willebrand factor [baseline]
16. soluble P-selectin [baseline]
17. MPO-AND [baseline]
18. atherosclerosis [baseline]
19. Aspirin treatment [baseline]
20. clamping duration [baseline]
21. bleeding [baseline]
22. vascular filling [baseline]
23. tranexamic acid administration [baseline]
24. transfusion [baseline]
25. amount of fibrinogen [baseline]
26. amount of heparin [baseline]
27. Type of postoperative anticoagulation [baseline]
28. Administration way of postoperative anticoagulation [Baseline]
