Chris I. Jones, PhD, David A. Payne, FRCS, Paul D. Hayes, MD, A

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The antithrombotic effect of dextran-40 in man is due to enhanced fibrinolysis in vivo Chris I. Jones, PhD, David A. Payne, FRCS, Paul D. Hayes, MD, A. Ross Naylor, MD, Peter R.F. Bell, MD, Mathew M. Thompson, MD, Alison H. Goodall, PhD Journal of Vascular Surgery Volume 48, Issue 3, Pages 715-722 (September 2008) DOI: 10.1016/j.jvs.2008.04.008 Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 1 Chandler loop thrombus weight and lysis. Patients were randomized to 100 mL of 10% dextran-40 (n = 10; closed circles, solid line) or 100 mL of saline (n = 10; open circles, dashed line). The data are shown as mean ± standard error of the mean. A, The weight (in mg) of thrombi formed over 90 minutes. B, The percentage reduction in thrombus weight over 24 hours. C, Release of fluorescein isothiocyanate-labelled fibrinogen from thrombi over 24 hours as measured by release of fluorescence, expressed as fluorescence units per mg initial thrombus weight. Journal of Vascular Surgery 2008 48, 715-722DOI: (10.1016/j.jvs.2008.04.008) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 2 The effect of dextran-40 infusion on plasma levels of fibrinolytic factors. Patients were randomized to 100 mL of 10% dextran-40 (n = 10; closed circles, solid line) or 100 mL of saline (n = 10; open circles, dashed line). The data are shown as mean ± standard error of the mean. A, Tissue plasminogen activator (tPA) antigen. B, Plasmin-antiplasmin (PAP) antigen. C, Plasminogen activator inhibitor type 1 (PAI-1) antigen. D, PAI-1 activity. Journal of Vascular Surgery 2008 48, 715-722DOI: (10.1016/j.jvs.2008.04.008) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 3 The effect of dextran-40 infusion on plasma levels of functionally active von Willebrand factor (vWF). Patients were randomized to 100 mL of 10% dextran-40 (n = 10; closed circles, solid line) or 100 mL of saline (n = 10; open circles, dashed line). The data are shown as mean ± standard error of the mean. Journal of Vascular Surgery 2008 48, 715-722DOI: (10.1016/j.jvs.2008.04.008) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 4 Effect of dextran-40 on the response of platelets in vitro. The percentage of platelets binding fibrinogen in response to maximal stimulation with adenosine diphosphate (ADP) at 1 × 10–5M, thrombin receptor activating peptide (TRAP) at 1 × 10–5M, or thrombin at 0.16 U/mL, in the presence or absence of 10% dextran-40 at a dose of 20 μL/mL (n = 3; P > .05 for all). Journal of Vascular Surgery 2008 48, 715-722DOI: (10.1016/j.jvs.2008.04.008) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 5 Effects of dextran infusion on platelet activity ex vivo. Patients were randomized to 100 mL of 10% dextran-40 (n = 10; closed circles, solid line) or 100 mL of saline (n = 10; open circles, dashed line). Data are shown as mean ± standard error of the mean. The percentage of platelets binding fibrinogen was measured in response to A, thrombin (0.16 U/mL), and B, thrombin receptor-activating peptide (1 × 10–5). Journal of Vascular Surgery 2008 48, 715-722DOI: (10.1016/j.jvs.2008.04.008) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions