Tissue plasminogen activator induced fibrinolysis: Standardization of method using thromboelastography

Alphan Kupesiz, Madhvi Rajpurkar, Indira Warrier, Wendy Hollon, Ozgur Tosun, Jeanne Lusher, Meera Chitlur

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40 Scopus citations


Fibrinolysis is a complex physiological process that involves the interaction of several anticoagulant proteins. Defects of the fibrinolytic system are extremely difficult to diagnose and study because there are no standardized tests available. Thromboelastography is a novel method that allows the study of both coagulation and fibrinolysis using one sample of whole blood, thereby allowing a more physiologic assessment of the coagulation process. Several in-vitro studies have been attempted to determine whether thromboelastography would be a useful assay for the study of fibrinolysis but have reported problems with reproducibility and reliability. Here we report the process involved in developing a thromboelastographic assay in which tissue plasminogen activator (t-PA) is used to induce fibrinolysis. The assay was standardized to ensure that the concentration of the coagulation inducer (tissue factor) and fibrinolytic agent (t-PA) was adequate to induce a clot with lysis parameters that were reproducible and reliable. This method can be used to rapidly assess the intrinsic fibrinolytic potential of whole blood. Our assay showed that it could rapidly predict high levels of plasminogen activator inhibitor, and this information would be beneficial in patients with acute stroke or myocardial infarction.

Original languageEnglish
Pages (from-to)320-324
Number of pages5
JournalBlood Coagulation and Fibrinolysis
Issue number4
StatePublished - Jun 2010


  • Fibrinolysis
  • Plasminogen activator inhibitor
  • Thromboelastography
  • Tissue factor
  • Tissue plasminogen activator


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