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Coagulation factor XIII-A and activated FXIII-A decrease in some deep vein thrombosis patients following catheter-directed thrombolysis

Hur, Woosuk S.a; Warner, Hannahb; Machan, Lindsayb; Kastrup, Christian J.a

Blood Coagulation & Fibrinolysis: June 2019 - Volume 30 - Issue 4 - p 176–180
doi: 10.1097/MBC.0000000000000797

The objective of the study was to assess the effect of tissue plasminogen activator administered during catheter-directed thrombolysis (CDT) on coagulation factor XIII (FXIII). Thrombolytic therapy carries significant risks, such as life-threatening bleeds. The mechanisms responsible for major bleeds and intracerebral hemorrhages during thrombolysis are not fully understood. Activated FXIII (FXIII-A*) lies at the intersection of coagulation and fibrinolysis. Using purified proteins and blood collected from nine deep vein thrombosis patients undergoing CDT, the stability of FXIII-A* and FXIII were measured immediately before, immediately after and 1-day post thrombolysis. We found that purified tissue plasminogen activator directly degraded FXIII-A. During CDT, FXIII levels were decreased by more than 40% in five of nine patients and FXIII-A* levels were decreased by more than 85% in two patients when it was activated. FXIII-A and FXIII-A* can decrease during CDT in some patients, warranting further research into the role of FXIII-A* in bleeding from thrombolysis.

aMichael Smith Laboratories, Department of Biochemistry and Molecular Biology, University of British Columbia

bDepartment of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada

Correspondence to Christian J. Kastrup, PhD, 2185 East Mall, Vancouver, BC VT6 1Z4, Canada Tel: +1 604 827 3749; e-mail:

Received 16 October, 2018

Revised 21 December, 2018

Accepted 21 January, 2019

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