The influence of haemoglobin and platelet levels on the results of arterial surgery

Bouhoutsos, John; Morris, Tom; Chavatzas, Demetrios; Martin, Peter

doi:10.1002/bjs.1800611215

Cited by 48 publications

(11 citation statements)

References 6 publications

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“…Three developed early thrombotic complications and the fourth died early in the postoperative period from a myocardial infarct. The high incidence of thrombotic and haemorrhagic complications associated with reconstructive vascular surgery in patients with these haematological abnormalities has been previously reported by Morris et al (1974).…”

Section: Discussionmentioning

confidence: 83%

The results of arterial reconstruction utilizing the profunda femoris artery in the treatment of rest pain and pre-gangrene

Hill

Jamieson

1977

Journal of British Surgery

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Arterial reconstruction utilizing the profunda femoris artery was performed for rest pain and pre-gangrene in 45 limbs. The preoperative mean ankle arterial pressure index of 0-21 (s.d. 0-12) was increased to 0-52 (s.d. 0-16) in the 22 limbs salvaged by the reconstruction. In 38 limbs a proximal reconstruction was necessary in addition to profundaplasty. At a mean follow-up time of 15-4 months 41-6 per cent of the 36 patients were dead.

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Section: Discussionmentioning

confidence: 83%

The results of arterial reconstruction utilizing the profunda femoris artery in the treatment of rest pain and pre-gangrene

Hill

Jamieson

1977

Journal of British Surgery

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“…It is well known that blood viscosity increases exponentially with haematocrit [3], and it is generally accepted that the success of recon structive arterial surgery depends largely on the blood flow in the operated segment, and therefore any factor which may influence the flow velocity may be important. Bohoutsos et al [2] found that the incidence of all com plications after surgery related to the higher preoperative haemoglobin concentration. Bailey et al [1] reported that preoperative haemoglobin was the best predictor of the outcome of distal amputation in diabetics.…”

Section: Discussionmentioning

confidence: 99%

Importance of the Preoperative Haemoglobin Concentration in Arterial Surgery

Mátrai¹,

Kollár²

1987

Eur Surg Res

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A study of reconstructive operations for ischaemia of the legs showed a correlation between a high preoperative haemoglobin level and early postoperative reocclusion. The mean preoperative haemoglobin level of patients with early reocclusion (165 ± 3 g/l, SEM) was significantly higher (p < 0.001) than that of patients who did not reocclude (153 ± 3 g/l). There was no significant difference in the total serum protein concentrations, suggesting that dehydration was not the cause of the difference observed in haemoglobin concentration. The mechanism may be the lower flow rate associated with the higher haemoglobin content and increased blood viscosity.

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“…76 Similarly, preoperative Hb values above 16 g/dL and platelet counts above 380 X 10 9 /L are associated with a greater risk of complications following arterial surgery. 77 Generally, calf blood flow increases following PCV reduction in patients presenting with PV. 78 As a group no improvement in oxygen transport is found, although this is shown in individual patients.…”

Section: Limb Blood Flow In Pvmentioning

confidence: 98%

Hemorheologic Considerations in the Pathogenesis of Vascular Occlusive Events in Polycythemia Vera

Pearson¹

1997

Semin Thromb Hemost

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Polycythemia vera (PV) commonly presents with vascular occlusion. Untreated patients have a poor prognosis due to the occurrence of thromboses. Treatment outcomes in PV and thrombotic events in other forms of polycythemia and in primary thrombocythemia lead to the conclusion that both raised packed cell volume (PCV) values and quantitative/qualitative platelet changes play a role in the pathogenesis of these vascular occlusive events. In vitro blood viscosity values are predominantly affected by the PCV, particularly at low shear rates and are thus high in untreated PV. Generally, under physiologic conditions blood flow is not governed by blood viscosity due to a number of factors, such as prevailing high shear rates, red cell axial migration, and adaptive vessel diameter changes. Peripheral blood flow is low in untreated PV. Whereas some untreated patients maintain adequate oxygen transport to the tissues, this may not apply in those with cardiac or local vessel disease. There is evidence that low flow rates predispose to occlusive events. Under pathologic low blood flow or static conditions, the rheologic blood changes of untreated PV, demonstrated in vitro, play a role in producing a more deleterious outcome of an occlusive event. Under blood flow conditions, red cell axial migration occurs. This leaves a plasmatic zone at the vessel wall into which platelets are dispersed and where shearing forces are maximal. These forces lead to platelet activation. Increased PCV values reduce the width of the plasmatic zone and lead to an increased possibility of platelet activation, platelet-platelet contact and platelet-vessel wall interaction, particularly when the platelet count is raised as well. These effects increase the likelihood of the initiation of thrombus formation in PV.

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The influence of haemoglobin and platelet levels on the results of arterial surgery

Cited by 48 publications

References 6 publications

The results of arterial reconstruction utilizing the profunda femoris artery in the treatment of rest pain and pre-gangrene

The results of arterial reconstruction utilizing the profunda femoris artery in the treatment of rest pain and pre-gangrene

Importance of the Preoperative Haemoglobin Concentration in Arterial Surgery

Hemorheologic Considerations in the Pathogenesis of Vascular Occlusive Events in Polycythemia Vera

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