Venous surgery in patients with congenital antithrombin III deficiency

Congenital antithrombin III (ATIII) deficiency, although uncommon, is a condition of considerable surgical importance. Affected patients are at significant risk of venous thrombosis during a surgical illness and standard forms of prophylaxis may not be effective. In addition, sequelae of their thromboses may in turn make them a candidate for venous surgery. An ATIII concentrate is now available in Australia for clinical use. This report describes two patients who underwent surgery for postphlebitic limbs utilizing infusions of ATIII concentrate. The ATIII deficiency state is reviewed and a method is described that should allow safe surgery in these patients.