Hypercoagulable states and lower limb ischemia in young adults

Jens Eldrup-Jorgensen, D. Preston Flanigan, Larry Brace, Alan P. Sawchuk, Sharon G. Mulder, Chris P. Anderson, James J. Schuler, Joseph R. Meyer, Joseph R. Durham, Thomas H. Schwarcz

Research output: Contribution to journalArticle

79 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)334-341
Number of pages8
JournalJournal of vascular surgery
Volume9
Issue number2
DOIs
StatePublished - Feb 1989
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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    Eldrup-Jorgensen, J., Flanigan, D. P., Brace, L., Sawchuk, A. P., Mulder, S. G., Anderson, C. P., Schuler, J. J., Meyer, J. R., Durham, J. R., & Schwarcz, T. H. (1989). Hypercoagulable states and lower limb ischemia in young adults. Journal of vascular surgery, 9(2), 334-341. https://doi.org/10.1016/0741-5214(89)90054-2