The Impact of Factor V Mutation on the Risk for Occlusion in Patients Undergoing Peripheral Vascular Reconstructions

Abstract

factor V mutation (Factor V-Leiden) was more frequent in patients having occluded vascular reconstructions. Further evaluation is needed.

A nationwide family study of venous thromboembolism and risk of arterial vascular disease

“…However, the same genetic factors involved in familial VTE, rs6025 and rs1799963, may be involved in ATE. Indeed one study has suggested that rs6025 may affect patency in patients undergoing vascular surgery 9. Therefore, it is possible that thrombophilic factors, which affect thromboembolism in the venous circulation, may also affect risk for arterial thromboembolism in places other than the heart or brain.…”

Prevalence and Risk of Thrombophilia Defects in Vascular Patients

“…16 Sampram et al's study again only tested for a single thrombophilia defect (Factor V mutation) and reported a prevalence of 16%. 17 Only three studies have looked at a typical cohort of patients with PVD. Ray et al recruited patients attending a vascular clinic with symptoms consistent with lower limb arterial disease.…”

“…Sampram also showed an increase in prevalence of Factor V Leiden in patients presenting with carotid disease (9%), aneurysmal disease (14%) and PVD (16%). 17 It has been assumed that a thrombophilia defect would affect the whole vascular tree presumably to the same degree. However, it is possible that thrombophilia defects are more prevalent in aggressive disease or lead to severe disease.…”

“…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'. 29 The limitation of this retrospective analysis is that only 18% of the group underwent formal thrombophilia screening and so the normal group might contain patients with a thrombophilia defect and there might be an underestimation of the prevalence of 13%.…”

The prevalence of thrombophilia in patients with symptomatic peripheral vascular disease

“…Thrombophilia defects are associated with failed revascularization in patients with peripheral vascular disease; the data suggest that the failure rate may be over three times higher than in patients without such defects1–9. Studies also suggest that hyperhomocysteinaemia is associated with vein graft stenosis10–12.…”