Hemostatic changes in patients with peripheral artery disease before and after bypass surgery

Abstract

To assess intrinsic coagulation pathway factors activity and hemostatic markers of endothelial dysfunction in patients with peripheral artery disease (PAD) before and after lower extremity bypass surgery. 80 patients with PAD Fontaine grade IIB-III were enrolled. 40 patients underwent open aorto-femoral-popliteal repair (group A) and 40 patients - medication (group B). Before and in 3 months after surgery peripheral venous blood samples were collected to assess the activity of factors VIII, IX, XI, von Willebrand factor (VWF), protein C (PrC), and metabolites of nitric oxide II (NO). Increased preoperative activity of VIII, IX, XI, and VWF factors compared with normal values was observed in group A. After 3 months there was an additional increase of VIII and VWF factors' activity. Activity of IX and XI factors remained increased on background of reduced level of NO metabolites. In group B increased activity of IX, XI, and VWF factors was revealed while levels of NO metabolites and PrC were normal. Thus, PAD is followed by prothrombotic state especially in patients after surgery. Surgical procedures are associated with more severe hypercoagulation.