Antibodies to cardiolipin may increase the risk of failure of peripheral vein bypasses

Nielsen, Tina; Nordestgaard, Børge G.; Jessen, E.; Andreasen, Jan Jesper; Wiik, Allan; Heegaard, Niels H H; Schroeder, Torben V.

doi:10.1016/s1078-5884(97)80188-8

Cited by 15 publications

(3 citation statements)

References 47 publications

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“…Mean graft patency for occluded lower limb procedures was 17 months in patients with APS and 50 months in those without. Nielsen et al 19 reported the results of 80 patients undergoing infrainguinal vein bypass surgery. Nine percent of patients had evidence of anticardiolipin antibodies.…”

Section: Discussionmentioning

confidence: 99%

Vascular graft thrombosis secondary to activated protein C resistance: a case report and literature review

Pejkić¹,

Savić²,

Paripović³

et al. 2013

Vascular

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Hypercoagulability is a well-documented and prominent risk factor for venous thromboembolism. The role of thrombophilia in arterial thrombotic events is less well defined. A 52-year-old male patient with multiple atherogenic risk factors was admitted for non-healing pedal ulcer and absent distal pulses. Based on the clinical presentation, Doppler ultrasound and angiography findings, the patient underwent elective in situ bypass arterial reconstruction. The saphenous vein graft was of satisfactory quality and the procedure went routinely. Acute graft thrombosis on postoperative day 0 was recognized immediately and prompted an emergent surgical revision. No technical errors or anatomical/mechanical causes for failed reconstruction were found and the graft was successfully thrombectomized using a Fogarty balloon-catheter. Graft rethrombosis, however, ensued after several hours. Considering the absence of threatening limb ischemia and the idiopathic recurrent thrombosis, raising suspicion of prothrombotic state, conservative treatment was pursued. Postoperative thrombophilia testing proved positive for activated protein C resistance, mandating introduction of chronic oral anticoagulation. Six months later, the operated extremity is viable. Inexplicable vascular graft thrombosis, particularly if early and recurrent, should raise suspicion of underlying thrombophilia. If confirmed by laboratory testing, long-term secondary antithrombotic prophylaxis may be required.

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Section: Discussionmentioning

confidence: 99%

Vascular graft thrombosis secondary to activated protein C resistance: a case report and literature review

Pejkić¹,

Savić²,

Paripović³

et al. 2013

Vascular

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“…Systemic variables that might associate with graft stenosis are lipoprotein (a), smoking and plasma fibrinogen, 25 hyperhomocystinemia, 26,27 and antibodies to cardiolipin. 28 The importance of vein quality has been also studied. The hypothesis of preimplantation morphologic changes in the saphenous vein as an etiologic factor of vein graft stenosis is disputed.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative flow predicts the development of stenosis in infrainguinal vein grafts

Ihlberg¹,

Albäck²,

Lassila³

et al. 2001

Journal of Vascular Surgery

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“…Graft thrombosis occurred in 57% of patients with an Anticardiolipin antibody compared to 30% (23/77) of those without. The overall primary patency at 6 months was even lower with 14% in those with Anticardiolipin antibodies compared to 57% in those without ðp ¼ 0:03Þ: 28 Sampram et al suggested that a factor V Leiden mutation was associated with a doubled rate of failure for infrainguinal procedures both at 1 month and 1 year (37% vs. 22% and 46% vs. 27%) but this was not statistically significant (p ¼ 0:15 and 0.09, respectively). 17 The recent publication by Curi et al reports that patients with hypercoagulability were more likely to have undergone prior revascularisation than patients deemed 'normal'.…”

Section: Thrombophilia and Vascular Riskmentioning

confidence: 98%

Prevalence and Risk of Thrombophilia Defects in Vascular Patients

Vig

Chitolie

Sleight

et al. 2004

European Journal of Vascular and Endovascular Surgery

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This paper reviews the available data on the prevalence of thrombophilia defects in patients with peripheral vascular disease (PVD) and attempts to delineate the risk of failure of vascular intervention in these patients. The prevalence of thrombophilia in stable claudicants is 25% and increases to 40% in those requiring revascularisation, compared to only 11% in the control group. The overall prevalence of thrombophilia defects in patients with premature atherosclerosis appears to be between 15 and 30%. The prevalence in the typical cohort of patients with PVD appears to be similar. All these studies have recruited patients with symptoms significant enough to warrant intervention. The overall prevalence of thrombophilia calculated from these trials, therefore, may not be truly indicative of the general vascular population who may not even present primary or secondary healthcare. The risk of thrombotic occlusion following arterial revascularisation in patients with an identified thrombophilia defect appears to be almost three times that of patients with no evidence of a thrombophilia defect. The best management of these patients has not been determined and needs to be evaluated by prospective randomized trials.

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Antibodies to cardiolipin may increase the risk of failure of peripheral vein bypasses

Abstract: Antibodies to cardiolipin were identified in 9% of patients undergoing infrainguinal vein bypass surgery and appeared to be associated with increased risk of bypass failure.

Cited by 15 publications

References 47 publications

Vascular graft thrombosis secondary to activated protein C resistance: a case report and literature review

Vascular graft thrombosis secondary to activated protein C resistance: a case report and literature review

Intraoperative flow predicts the development of stenosis in infrainguinal vein grafts

Prevalence and Risk of Thrombophilia Defects in Vascular Patients

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