HEMOSTASIS AND HEMORHEOLOGY AFTER ISCHEMIC STROKE IN PATIENTS WITHOUT CARDIOPATHY AND OTHER LOCALISATION OF ATHEROSCLEROSIS

Hemorheological parameters (whole blood filtration, whole blood viscosity, plasma viscosity and erythrocyte deformability by ektacytometry) and fibrinolysis parameters (Euglobulin Lysis Time ELT, t-PA activity, and Plasminogen ActivatorInhibitor -PAI- before and after Venous Occlusion Test -VOT-) were measured in 20 stroke patients. All these patients had a crerebrovascular accident (CVA) localised to the carotid arterial tree. They has no signs of heart disease and were without risk factors for atherosclerosis (high blood pressure, diabetes) ; they were investigated in the week following the CVA. They were divided into 4 groups : 1/ transcient ischemic accident, 2,3,4/ size of infarct classified from results of C. T. Scan carried out 2 or 3 days after the stroke (2/small +, 3/moderate ++, 4/large +++).

For the hemorheological parameters we noted only a slight increase in whole blood filtration (27±8“ vs 21±2”, p<0,05).

The ELT was however significantly increased in these patients (258 ±57 min. vs 133 ±33,p<0,001)suggesting impairement of fibrinolysis. The following points were noteworthy : the ELT return to normal after to VOT,there was a relationship between stroke severity and the PAI levels and the viscosity at low shear stress. These two parameters were dramatically impaired in the most severely affected patients. Transcient ischemic accidents had comparable features to the CVA of moderate size.

The extend of the disorders of the hemorheological disorders and the abnormalities in fibrinolysis seemed to be related to the severity of the involvement in patients with ischemic stroke with no evidence of heart disease or atherosclerosis in other systems.