TY  - JOUR
A1  - Häußler, Katja Susanne
A1  - Keese, Michael
A1  - Weber, Christian Friedrich
A1  - Geisen, Christof
A1  - Miesbach, Wolfgang
T1  - Prospective evaluation of the pre-, intra-, and postoperative kinetics of ADAMTS-13, von Willebrand factor, and interleukin-6 in vascular surgery
T2  - Clinical and applied thrombosis, hemostasis
N2  - Postoperative thrombotic thrombocytopenic purpura (TTP) shows clinical presentation similar to classical TTP, whereas exact pathophysiological contexts remain unexplained. In this study, we investigated intraoperative and postoperative changes in ADAMTS-13 (a disintegrin and metalloprotease with thrombospondin type 1 motifs, member 13), von Willebrand factor (VWF), large VWF multimers, and interleukin-6 (IL-6) in vascular surgery patients. The objective was to compare the impact of endovascular, peripheral, and aortic surgery on target parameters which are supposed to play a role in surgery-associated TTP. A total of 93 vascular surgery patients were included and divided into 4 groups according to the specific type of intervention they underwent. Blood samples were taken preoperatively, intraoperatively, and postoperatively on days 2 and 4. The ADAMTS-13 activity decreased significantly in 3 of the 4 groups during surgery (from median 81% to 49%, P < .001, in the group undergoing aortoiliacal interventions), whereas the percentage of large VWF multimers increased in all groups of patients. von Willebrand factor antigen increased significantly in all groups on postoperative day 2 and IL-6 increased significantly in the intraoperative and early postoperative period. There was no significant correlation between the intraoperative decrease in ADAMTS-13 and the increase in VWF or IL-6. No patient in this study showed clinical picture of TTP; the precise cause and clinical significance of moderately reduced ADAMTS-13 activity in the perioperative setting have not yet been definitely determined.
KW  - ADAMTS-13
KW  - vascular surgery
KW  - von Willebrand factor
KW  - interleukin-6
KW  - thrombotic thrombocytopenic purpura
KW  - thrombotic microangiopathy
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/55989
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-559890
SN  - 1938-2723
SN  - 1076-0296
VL  - 26
PB  - Sage
CY  - Thousand Oaks, Calif.
ER  -