Dynamic Changes And Guiding Role Of D-dimer In Cerebral Venous Sinus Thrombolysis

Background and purpose:D-Dimer(D-Dimer,DD)is a degradation product of cross-linked fibrin and reflects systemic coagulation and fibrinolytic activity.In recent years,it has become a diagnostic standard and monitoring index for various thrombotic diseases.Plasma Ddimer testing is not only widely used for screening acute thrombotic diseases,but also an auxiliary evaluation method for the fibrinolytic effect of deep vein thrombosis,pulmonary embolism,stroke,myocardial infarction,etc.However,the changes in plasma concentration of D-dimer during thrombolysis in patients with venous sinus thrombosis and the value of clinical monitoring are still unclear.Methods:A retrospective analysis of 15 patients who received thrombolysis of sinus catheters in our hospital from January 2014 to December 2019,all patients were diagnosed by cerebral angiography(Digital Subtraction Angiography,DSA).All patients used urokinase(Urokiase,UK)as a thrombolytic agent.Intravenous 3D delayed rotation angiography showed that:<30%of residual thrombosis was in the basic dissolution group,>70%of residual thrombosis was in the undissolved group,and the rest was partial group.Dynamic monitoring of plasma D-dimer concentration during thrombolysis.Results:The value of D-dimer increased rapidly after thrombolysis in the basic Rongtong group,reached its peak around 6 hours,and then slowly fluctuated and decreased;some Rongtong groups fluctuated and increased,and multiple peaks appeared,and the highest peak appeared later,then Decline slowly;the D-dimer curve of the undissolved group is low and flat,with little fluctuation.Dynamic monitoring of thrombolysis 18hD-dimer and peak time can help predict the success of thrombolysis(DD peak time:AUC(95%CI)=0.815(0.6542,0.9754);Cut-off value=56.5h;thrombolysis 18hD-dimer level:AUC(95%CI)=0.775(0.5637,0.9863)Cut-off value=2358ng/ml).Conclusion:Venous sinus catheter thrombolysis is a safe and effective method for the treatment of CVST.D-dimer concentration analysis can become a predictive indicator for non-invasive monitoring of thrombolysis during CVST patients during catheter thrombolysis.