Hypercoagulable states and lower limb ischemia in young adults

• Published in: Journal of vascular surgery Vol. 9; no. 2; pp. 334 - 341
• Main Authors: Eldrup-Jorgensen, Jens, Flanigan, D.Preston, Brace, Larry, Sawchuk, Alan P., Mulder, Sharon G., Anderson, Chris P., Schuler, James J., Meyer, Joseph R., Durham, Joseph R., Schwarcz, Thomas H.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Mosby, Inc 01-02-1989; Elsevier
• Subjects: Adult; Antithrombin III - analysis; Autoantibodies - analysis; Biological and medical sciences; Blood and lymphatic vessels; Blood Coagulation Disorders - blood; Blood Coagulation Disorders - epidemiology; Blood Coagulation Factors - analysis; Blood Coagulation Factors - immunology; Blood Coagulation Tests; Cardiology. Vascular system; Cohort Studies; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Glycoproteins - analysis; Humans; Ischemia - surgery; Leg - blood supply; Lupus Coagulation Inhibitor; Male; Medical sciences; Middle Aged; Phospholipids - analysis; Platelet Aggregation; Prognosis; Prospective Studies; Protein C - analysis; Protein S; Human; Hypercoagulability; Chronic; Young adult; Lower limb; Cardiovascular disease; Arterial occlusive disease
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/0741-5214(89)90054-2

This study prospectively evaluates hypercoagulable states in patients under 51 years of age undergoing lower extremity revascularization for ischemia and assesses early outcome after operation. Twenty patients whose ages range from 23 to 50 years (mean 40.8 years) were identified prospectively who underwent lower extremity revascularization and evaluation of hypercoagulability. Fifteen patients were male (75%), 10 were black (50%), six had hypertension (30%), and four were diabetic (20%). All but two were cigarette smokers (90%). Seven aortoiliac procedures and 13 infrainguinal procedures were performed. Six patients had one or more abnormalities of regulatory proteins (protein S deficiency, four; protein C deficiency, three; presence of lupus-like anticoagulant, three; plasminogen deficiency, two). Eight of 17 patients in whom platelet aggregation profiles were obtained showed increased reactivity (47%). Only 4 of 17 patients (24%) were normal when tested for all parameters. Arterial or graft thrombosis developed in four of the 20 patients within 30 days after operation. Hypercoagulability was found in all four patients whose revascularizations failed. A high incidence of hypercoagulable states was found in patients under 51 years of age with lower limb ischemia requiring revascularization. Hypercoagulability may have contributed to early postoperative thrombosis of the vascular procedure.