Background: Development of intraluminal thrombus (ILT) in the abdominal aortic aneurysm (AAA) is a natural reaction to lesion of the arterial wall. Local hemostatic processes and secondary fibrinolysis in the intraluminal thrombus, through the activation of proteolysis in the extracellular matrix may constitute one of the factors that lead to an aneurysm rupture. In our study we compared some coagulation and fibrinolysis parameters in the layer of the thrombus directly adjacent to the aneurysmal wall, between the thinner and thicker part of the intraluminal thrombus.

Methods: The sections sampled for the study were harvested from the thick (more than 25 mm) and thin (up to 10 mm) slices of the ILT obtained from the same 32 abdominal aortic aneurysms, namely from the layer directly adjacent to the aneurysmal wall. Immediately after sampling the thrombus was washed in saline and the homogenate was prepared. The tissue factor (TF), antiheparin (AH) and antithrombin (AT) activities, plasminogen (PLG) and plasminogen activators levels (PA) and content of D-Dimers (D-D) in the samples were measured. The TF and AH activities were expressed by shortening of the coagulation time compared to the NaCl control. The AT activity was expressed by prolongation of the coagulation time as compared to the saline. PLG and PA levels were measured by the chromogenic and Elisa methods, respectively. D-D content were measured by the immunoturbidimetric assay.

Results: The activities of TF and AH in the abluminal layer of the ILT were statistically significantly higher in the thin thrombi than in the thick ones (p<0.001). Moreover, thin thrombi revealed significantly higher PLG and D-D levels when compared to thick thrombi (p<0.001), while the activity of PA was higher in the thick thrombi (p<0.05).

Conclusions: The abluminal layer of the thin thrombus (up to 10 mm) of the AAA shows higher activities of coagulative processes when compared to thicker thrombi (over 25 mm). Moreover, this site reveals strong secondary activation of fibrinolytic system. Further investigation of association between coagulation/fibrinolytic activity and proteolysis occurring within the AAA wall requires evaluation of such processes with regard to differences in the thickness of the thrombus.

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