Semin Thromb Hemost 2016; 42(04): 381-388
DOI: 10.1055/s-0036-1579636
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

How to Assess Fibrinogen Levels and Fibrin Clot Properties in Clinical Practice?

Anetta Undas
1   Institute of Cardiology, Jagiellonian University Medical College, Cracow, Poland
2   Center for Research and Medical Technology, John Paul II Hospital, Cracow, Poland
› Author Affiliations
Further Information

Publication History

Publication Date:
12 April 2016 (online)

Abstract

Fibrin formed from fibrinogen is the main component of thrombi. Clot structure is characterized by fiber thickness and pore size, which differs within a given clot and between individuals. Plasma clot architecture is largely determined by the quantity and quality of fibrinogen. Plasma fibrinogen concentrations are most commonly measured in citrated plasma using the Clauss method. However, several factors, including instrument type and reagent, may affect results. Other approaches to express the ability of fibrinogen to clot involve prothrombin time–derived or clottable protein assays, while fibrinogen antigen levels in clinical settings are measured using immunological or precipitation assays. Fibrin clot permeability (reflected by the Darcy constant, K s) being proportional to a buffer volume percolating through a clot under a given hydrostatic pressure is now the most commonly used measure of clot structure. Low K s values indicating tightly packed fibrin structure have been shown to be associated with venous and arterial thrombotic complications, while high K s might contribute to bleeding disorders. The measurement of K s, however, is not standardized and validated. This review summarizes the current knowledge on practical aspects of the measurement of fibrinogen levels and K s in patients.

 
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