Hypercoagulable states in patients with leg ischaemia.

Ray, S. A.; Rowley, M. R.; Loh, A.; Talbot, S. A.; Bevan, D. H.; Taylor, R. S.; Dormandy, J. A.

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 hyper-coagulation abnormality (low levels of protein C, protein S and antithrombin III or presence of the lupus anti-coagulant) 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.

British Journal of Surgery, 1994, Vol 81, Issue 6, p811

0007-1323

Academic Journal

10.1002/bjs.1800810607