Periprocedural coagulation and fibrinolytic changes after sclerotherapy for venous malformations.
Thrombin-antithrombin complex level accurately detects post-sclerotherapy hemostatic activation in venous malformations
Periprocedural coagulation and fibrinolytic changes after sclerotherapy for venous malformations.
To prospectively characterize peri-procedural changes in thrombin-antithrombin complex (TAT), plasmin-α2-plasmin inhibitor complex (plasmin inhibitor complex), fibrin/fibrinogen degradation products (fibrinogen degradation products), D-dimer, thrombomodulin (thrombomodulin), and tissue plasminogen activator-inhibitor complex (t-PAIC) in patients with venous malformations (venous malformations) undergoing percutaneous sclerotherapy.
This prospective single-center observational study included 68 patients with venous malformations and 48 healthy controls.
TAT correctly separated cases from controls almost every time
Local lesional samples showed higher TAT, plasmin inhibitor complex, fibrinogen degradation products, and D-dimer concentrations than paired preoperative peripheral samples, whereas thrombomodulin and t-PAIC did not differ significantly.
After sclerotherapy, TAT increased immediately, while D-dimer showed a more prolonged postoperative elevation.
The TAT/plasmin inhibitor complex ratio also increased immediately after treatment, suggesting a transient laboratory shift toward coagulation predominance.
No symptomatic venous thromboembolism, pulmonary embolism, overt disseminated intravascular coagulation, or major bleeding was observed during 30-day follow-up.
In patients with venous malformations undergoing sclerotherapy, TAT showed an immediate post-procedural increase consistent with acute thrombin generation, whereas D-dimer showed a more sustained postoperative pattern.
These findings describe peri-procedural hemostatic activation and support further outcome-based evaluation of TAT and TAT/plasmin inhibitor complex.