Ischaemia and Reperfusion During Open Abdominal Aortic Aneurysm Surgery Induce Extensive Thrombin Generation and Activity

AbstractObjectives:does open surgery for abdominal aortic aneurysm (AAA) influence coagulation?Methods:in 23 patients operated on for AAA, cubital blood was sampled pre-, intra- and postoperatively. Femoral blood was also sampled intraoperatively.Results:preoperatively, prothrombin fragment 1+2 (F1+2), thrombin–antithrombin complex (TAT) and soluble fibrin (SF) were elevated in AAA patients. During aortic clamping all parameters increased significantly in cubital blood (p<0.01) as well as in femoral blood (p<0.001) and after aortic declamping F1+2 and TAT increased further. F1+2, TAT and SF were significantly higher in femoral than cubital blood. Postoperatively F1+2 and TAT returned to preoperative values, while SF still had a significantly higher level than preoperatively (p<0.001). Blood loss showed co-variation with F1+2 increase in femoral blood after aortic declamping (p