Extended Monitoring of Hemostatic Activation After Varicose Vein Surgery Under General Anesthesia

BACKGROUND Postoperative heparin prophylaxis after stripping of the long saphenous vein is a matter of controversial discussion, and practices vary by surgeon and country. OBJECTIVE The aim of this study was to assess the extent of hypercoagulability by continued monitoring of activation markers of...

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Bibliographic Details
Published in:Dermatologic surgery 2006-05, Vol.32 (5), p.632-639
Main Authors: HINTERHUBER, GABRIELE, BÖHLER, KORNELIA, KITTLER, HARALD, QUEHENBERGER, PETER
Format: Article
Language:English
Subjects:
Adult
alpha-2-Antiplasmin - analysis
Anesthesia, General
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Dermatology
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Female
Fibrin - analysis
Fibrin Fibrinogen Degradation Products - analysis
Fibrinolysin - analysis
Fibrinolysis - physiology
Humans
Male
Medical sciences
Middle Aged
Monitoring, Physiologic
Peptide Fragments - blood
Postoperative Period
Prothrombin
Saphenous Vein - surgery
Skin plastic surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Varicose Veins - surgery
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Summary:BACKGROUND Postoperative heparin prophylaxis after stripping of the long saphenous vein is a matter of controversial discussion, and practices vary by surgeon and country. OBJECTIVE The aim of this study was to assess the extent of hypercoagulability by continued monitoring of activation markers of coagulation and fibrinolysis for a period of 3 weeks after stripping of the long saphenous vein and concomitant phlebectomy. METHODS Including 21 patients, the following markers were measured preoperatively and on postoperative day 1, 2, 3, 7, 14, and 21: Activation products of coagulation: thrombin‐antithrombin complex (TAT), thrombus precursor protein (TPP), and prothrombin‐fragment F1+2 (F1+2), and markers of fibrinolysis: plasmin‐α2‐antiplasmin complexes (PAP), D‐Dimer, tissue plasminogen activator (t‐PA) antigen, and plasminogen activator inhibitor 1 (PAI‐1) antigen. RESULTS TAT levels increased significantly until day 3 (p=.008) and normalized within 14 days. TPP levels increased significantly until day 7 (p=.02), decreasing to initial values within 21 days. PAP complexes increased significantly until day 2 (p=.02) reducing to baseline within the observation period. D‐Dimer levels increased immediately after surgery (p
ISSN:1076-0512
1524-4725
DOI:10.1111/j.1524-4725.2006.32134.x