Why is there a surge of creatine kinase (CK) when extracting a thrombus?

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From the Research

A surge of creatine kinase (CK) during thrombus extraction occurs because the procedure can cause muscle damage and tissue injury, as evidenced by the release of CK into the bloodstream following reperfusion of previously ischemic tissue 1. When a thrombus (blood clot) is extracted from a blood vessel, particularly during procedures like thrombectomy for stroke or myocardial infarction, the reperfusion of previously ischemic tissue leads to cellular damage. As blood flow returns to oxygen-deprived tissues, cells that were damaged during the ischemic period release their contents, including CK, into the bloodstream. Some key points to consider:

  • Creatine kinase is an enzyme primarily found in muscle tissues, including cardiac muscle, skeletal muscle, and brain tissue.
  • Its elevation serves as a biomarker for tissue damage, with levels typically rising within hours after injury and peaking within 24-48 hours.
  • This CK elevation is actually expected following successful reperfusion and doesn't necessarily indicate a complication, but rather confirms that blood flow has been restored to previously ischemic tissue.
  • The mechanical manipulation during the extraction procedure itself can cause minor trauma to surrounding tissues, contributing to the release of CK into the bloodstream.
  • Studies have shown that the release of CK into the bloodstream is a common occurrence after physical exercise, and its levels can be influenced by various factors, including ethnicity, age, and gender 2, 1. However, in the context of thrombus extraction, the surge of CK is more likely related to the reperfusion injury and tissue damage caused by the procedure, rather than the physical exercise itself. It's worth noting that the use of analgesics such as ibuprofen and acetaminophen may not have a significant impact on the release of CK into the bloodstream after exercise 3, 4, but this may not be directly applicable to the context of thrombus extraction. Overall, the surge of CK during thrombus extraction is a complex phenomenon that requires careful consideration of the underlying mechanisms and factors involved.

References

Research

The creatine kinase response to resistance exercise.

Journal of musculoskeletal & neuronal interactions, 2014

Research

Effect of ibuprofen and acetaminophen on postexercise muscle protein synthesis.

American journal of physiology. Endocrinology and metabolism, 2002

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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