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Vol. 24, Art. 92 (pp. 1357-1367)    |    2023       

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Hemostatic blood potential of patients after arterial reconstructions of the lower limb

Komissarov K.A.1,2, Soldatenkov V.E.1, Bessmeltsev S.S.1, Burakov V.V.1, Soldatenkova O.V.1, Papayan L.P.1

1 - Russian Research Institute of Hematology and Transfusiology of the Federal Medical and Biological Agency, St. Petersburg
2 - St. Petersburg State Pediatric Medical University, St. Petersburg

Brief summary

Atherosclerosis is a chronic systemic disease. The pathogenesis of atherosclerosis is closely related to the activation of the hemostasis system and the formation of a hypercoagulable state. Activation of the hemostasis system causes excessive formation of thrombin, which leads to thrombosis of the vessels of the microvasculature and inhibition of the activity of natural anticoagulants: antithrombin and the system of proteins C and S. For clinical practice, a method for global assessment of the state of the hemostasis system is presented - the thrombin generation test. Objective. To assess the state of the hemostasis system in patients with obliterating atherosclerosis of the arteries of the lower extremities before and after reconstructive surgery on the arteries of the lower extremities. Materials and methods. The state of the hemostatic system was assessed in 64 patients with obliterating atherosclerosis of the arteries of the lower extremities without and after reconstructive surgery on the arteries of the lower extremities. Results. An increase in the hemostatic potential of blood was revealed in all patients with arterial diseases, to a greater extent in patients who underwent long-term surgical interventions due to a significant increase in fibrinogen concentration, factor VIII activity, activity and content of von Willebrand factor. The thrombin generation test in groups of patients after reconstructive interventions on the arteries of the lower extremities revealed not only a significant increase in thrombin generation, but also a decrease in the efficiency of the protein C system. Conclusion. The use of a thrombin generation test in combination with the determination of factor VIII activity, fibrinogen concentration, homocysteine level, von Willebrand factor activity and content will increase the prognostic value of assessing the hemostatic potential of the blood of patients with atherosclerotic diseases of the arteries of the lower extremities before the forthcoming surgery.


Key words

hypercoagulability, atherosclerosis obliterans, hemostasis, thrombosis, thrombophilia, hemostatic potential, thrombin generation

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