The fibrinolytic activity of varicose veins

The plasma fibrinogen concentration, plasma fibrinolytic activity and the vein wall fibrinolytic activity of hand, groin, knee, ankle and perforating veins have been studied in 10 patients with skin changes in the lower leg secondary to venous disease (lipodermatosclerosis), in 10 patients with uncomplicated varicose veins and in 17 normal volunteers undergoing surgery. There was significantly more vein wall fibrinolytic activity in normal volunteers than in the patients with lipodermatosclerosis, not only in the ankle (P less than 0.001) but also in the hand (P less than 0.05). It is suggested that the reduced tissue fibrinolytic activity is a causative factor in the skin changes and ulceration of the post-phlebitic leg, and that since the reduced activity is not confined to the leg, it may be a primary systemic defect rather than a state secondary to venous congestion.