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Hypercoagulable states and lower limb ischemia in young adults
J Eldrup-Jorgensen1, D P Flanigan, L Brace
1Department of Surgery, University of Illinois College of Associated Health Professions, Chicago.
Journal of Vascular Surgery
|February 1, 1989
Summary
Younger patients undergoing lower extremity revascularization frequently have hypercoagulable states. These blood clotting disorders may contribute to early graft thrombosis after vascular surgery.
Area of Science:
- Vascular Surgery
- Hematology
- Thrombosis Research
Background:
- Lower extremity ischemia often requires revascularization.
- Hypercoagulable states are associated with thrombosis but are less studied in younger surgical patients.
Purpose of the Study:
- To prospectively evaluate hypercoagulable states in patients under 51 years old undergoing lower extremity revascularization.
- To assess the association between hypercoagulability and early postoperative outcomes.
Main Methods:
- Prospective evaluation of 20 patients (<51 years) undergoing lower extremity revascularization.
- Assessment of hypercoagulable states, including regulatory proteins and platelet aggregation.
- Analysis of early postoperative outcomes, specifically graft thrombosis.
Main Results:
- A high incidence of hypercoagulable states was observed (76% abnormal in tested parameters).
- Specific abnormalities included protein S deficiency, protein C deficiency, lupus-like anticoagulant, and plasminogen deficiency.
- Four patients (20%) experienced arterial or graft thrombosis within 30 days; all had hypercoagulable states.
Conclusions:
- Younger patients undergoing lower extremity revascularization exhibit a high prevalence of hypercoagulable states.
- Hypercoagulability is strongly associated with early graft failure and thrombosis in this population.
- Further investigation into screening for hypercoagulability in this demographic is warranted.