Systemic activation of coagulation and fibrinolysis during varicose vein stripping.
BACKGROUND
Elevation of activation markers of blood coagulation (thrombin-antithrombin complex [TAT], prothrombin fragment 1 + 2 [F1 + 2], D-Dimer] has not only been found in clinically overt thrombosis but also reflects a prethrombotic state.


OBJECTIVE
The purpose of our study was to evaluate whether varicose vein stripping, an operative procedure with an extremely low risk of postoperative thromboembolism, induces a prethrombotic state by activation of the hemostatic system.


METHODS
In a prospective, observational study we compared the baseline and postoperative values of TAT, F1 + 2, and D-Dimers in 15 patients undergoing varicose vein stripping and in 11 control patients undergoing surgical procedures associated with only minor soft tissue trauma.


RESULTS
A highly significant postoperative elevation of TAT (P < 0.001), F1 + 2 (P = 0.006), and D-Dimer (P < 0.001) was observed in the varicose vein stripping group. No significant postoperative change of the respective parameters was detected in the control group.


CONCLUSIONS
We therefore conclude that varicose vein stripping induces a significant hemostatic system activation although postoperative thrombotic events are rare.
Böhler
K
K
Department of Dermatology, University of Vienna Medical School, Austria.
Hinterhuber
G
G
Binder
M
M
Watzke
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001777:Blood Coagulation / Q000502:physiology*; D005260:Female; D005342:Fibrinolysis / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood* / Q000517:prevention & control; D011184:Postoperative Period; D011446:Prospective Studies; D013923:Thromboembolism / Q000097:blood* / Q000517:prevention & control; D014648:Varicose Veins / Q000601:surgery*