Effects on blood coagulation, fibrinolysis, and platelet aggregation of normal and atheronatous aortic tissue.

A comparison was made between the effects of atheromatous and normal areas of the same aorta on coagulation, fibrinolytic, and platelet aggregating systems. In the thromboplastin generation test it was found that atheromatous aorta possessed significantly greater ability to generate intrinsic prothrombin activator than did normal aortic tissue. But, by the one-stage prothrombin time technique, the content of extrinsic thromboplastin in both types of aorta was similar. Aortic preparations, consisting of intimal and medial layers only, were not found to possess fibrinolytic ability and did not contain inhibitors of the fibrinolytic system. The adhesion of platelets to ulcerated atheromatous areas of aorta was significantly greater than to normal or non-ulcerated atheromatous areas. However, homogenates of atheromatous and normal aorta did not differ in their ability to accelerate platelet aggregation and fibrin clot formation when tested by a modified Chandler's tube technique. The significance of the findings is discussed and the suggestion made that the mechanisms by which atheromatous aortic tissue might predispose towards intravascular thrombosis in vivo are the ability of such tissue to enhance intrinsic prothrombin activator formation and platelet aggregation.