Arterial thrombosis associated with heterozygous factor V Leiden disorder, hyperhomocysteinemia, and peripheral arterial disease: importance of synergistic factors.
A 47-year-old man with heterozygous factor V Leiden disorder and intermittent hyperhomocysteinemia developed spontaneous acute popliteal artery thrombosis. Homocysteine levels were above normal limits at presentation. Intra-arterial thrombolysis was used successfully to treat the acute thrombosis; long-term treatment included anticoagulation, folic acid, and risk factor modification. Although factor V Leiden is strongly associated with deep venous thrombosis, additional cofactors such as hyperhomocysteinemia may predispose to an increased risk of acute arterial thrombosis in areas of pre-existing peripheral arterial disease.
Page
Cameron
C
Department of Surgery, VA Connecticut Healthcare System, Yale University School of Medicine, New Haven, CT 06519, USA.
Rubin
Lee E
LE
Gusberg
Richard J
RJ
Dardik
Alan
A
D000208:Acute Disease; D000792:Angiography; D005165:Factor V / Q000235:genetics; D005166:Factor V Deficiency / Q000097:blood / Q000150:complications* / Q000235:genetics; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D005500:Follow-Up Studies; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D006579:Heterozygote; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000150:complications*; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009154:Mutation; D016491:Peripheral Vascular Diseases / Q000150:complications*; D011150:Popliteal Artery; D013923:Thromboembolism / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D005165:Factor V; D006493:Heparin; D010959:Tissue Plasminogen Activator