Endogeneous fibrinolysis and restenosis of peripheral arteries after percutaneous transluminal angioplasty

Abstract

To assess the role of the fibrinolytic system in the pathogenesis of restenosis after percutaneous transluminal angioplasty (PTA) of peripheral arteries, 166 consecutive patients with peripheral atherosclerotic disease, ranging from 36 to 86 years old (median = 60), who had undergone successful PTA, were followed for 1 year. Tissue plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1) antigens were determined before PTA and at 3, 6 and 12 months after, while t-PA activity, PAI-1 activi ty, fibrinogen, plasminogen, euglobulin clot lysis time anda2-antiplasmin were determined at 3 months after PTA. There were no significant differences in fibrinolytic parameters between patients with patent (121 patients – 73%) and those with restenosed (45 patients – 27%) arteries. Restenosis was more common in patients with poor outflow (17 out of 44 patients) than with good outflow (28 out of 122 patients;P< 0.05), with pre-existent occlusion (27 out of 93 patients) than with preexistent stenosis (17 out of 73 patients;P< 0.05), and with symptoms lasting longer than 6 weeks (35 out of 108 patients) than with symptoms lasting less (10 out of 58 patients;P< 0.05). We concluded that measured fibrinolytic parameters were not related to post-PTA restenosis, suggesting that the endogenous fibrinolytic system, estimated in peripheral blood, does not influence the development of restenosis in a peripheral artery.