Therapeutic defibrinogenation in peripheral vascular disease.

Despite considerable uncontrolled clinical data implying a beneficial effect of defibrinogenation in peripheral vascular disease, this is not supported by double blind placebo controlled trials. A hypothetical explanation for this discrepancy is developed from experimental studies suggesting that in the absence of adequate shear forces defibrinogenation might induce occlusion of the impaired microcirculation and therefore can lead to an aggravation of tissue hypoxia.