Hypercoagulable states in patients with leg ischaemia.
Hypercoagulable states are found in up to 10 per cent of patients with a history of unexplained venous thrombosis. To investigate the prevalence in arterial thrombosis, thrombophilia screening was performed on 124 patients who had previously undergone lower-limb revascularization, 45 claudicants and 27 controls. Of the patients who had undergone revascularization 40 per cent had a hypercoagulation abnormality (low levels of protein C, protein S and antithrombin III or presence of the lupus anticoagulant) in comparison with 27 per cent of claudicants and 11 per cent of controls (P < 0.01). Furthermore, patients who had suffered reocclusion after revascularization were significantly more likely to have a hypercoagulation abnormality than those who had not (P < 0.05), even if the occlusion had occurred more than 6 months previously. Lupus anticoagulant was the abnormality most frequently detected and, like low protein C levels, was found only in patients with peripheral vascular disease. It appears that hypercoagulable states are common in patients with arterial disease and may predispose to failure of revascularization.
Ray
S A
SA
Department of Vascular Surgery, St George's Hospital Medical School, London, UK.
Rowley
M R
MR
Loh
A
A
Talbot
S A
SA
Bevan
D H
DH
Taylor
R S
RS
Dormandy
J A
JA
D000368:Aged; D000990:Antithrombin III / Q000032:analysis; D001778:Blood Coagulation Disorders / Q000097:blood / Q000150:complications*; D001807:Blood Vessel Prosthesis; D005260:Female; D006083:Graft Occlusion, Vascular / Q000097:blood; D006801:Humans; D007511:Ischemia / Q000097:blood / Q000150:complications* / Q000601:surgery; D007866:Leg / Q000098:blood supply*; D016682:Lupus Coagulation Inhibitor / Q000032:analysis; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011486:Protein C / Q000032:analysis; D017293:Protein S / Q000032:analysis; D014680:Veins / Q000637:transplantation
D016682:Lupus Coagulation Inhibitor; D011486:Protein C; D017293:Protein S; D000990:Antithrombin III