Thrombelastographic Patterns following Abdominal Aortic Surgery

Postoperative changes in thrombelastographic patterns were studied in thirty patients undergoing elective abdominal aortic bypass surgery. Native whole blood thrombelastography was performed preoperatively and on days 1, 2, and 3 postoperatively. The thrombelastographic changes included a decrease in r on day one (P < 0.0001), with concurrent increases in α (P < 0.0001) and MA (P < 0.001). On days 2 and 3 there were further increases in MA (P < 0.0001). These changes indicate enhanced procoagulant activity and progressive increases in maximum clot strength. The results confirm that hypercoagulability occurs in whole blood following abdominal aortic bypass surgery. Further studies are warranted to determine whether modification of postoperative hypercoagulability reduces the incidence of thrombotic complications in this group of patients.

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Postoperative changes in coagulant and anticoagulant factors following abdominal aortic surgery

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1016/1053-0770(92)90051-8 ◽

1992 ◽

Vol 6 (6) ◽

pp. 680-685 ◽

Cited By ~ 45

Author(s):

Neville M. Gibbs ◽

G. Patrick ◽

M. Crawford ◽

Nick Michalopoulos

Keyword(s):

Aortic Surgery ◽

Abdominal Aortic Surgery ◽

Postoperative Changes ◽

Abdominal Aortic

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A Comparison of Postoperative Thrombotic Potential following Abdominal Aortic Surgery, Carotid Endarterectomy, and Femoro-Popliteal Bypass

Anaesthesia and Intensive Care ◽

10.1177/0310057x9602400102 ◽

1996 ◽

Vol 24 (1) ◽

pp. 11-14 ◽

Cited By ~ 18

Author(s):

N M Gibbs ◽

G P M Crawford ◽

N Michalopoulos

Keyword(s):

Vascular Surgery ◽

Carotid Endarterectomy ◽

Protein C ◽

Aortic Surgery ◽

Plasminogen Activator Inhibitor ◽

Abdominal Aortic Surgery ◽

Postoperative Changes ◽

Abdominal Aortic ◽

Activator Inhibitor

Postoperative changes in procoagulant, anticoagulant, and antifibrinolytic factors were compared in patients undergoing abdominal aortic surgery, carotid endarterectomy, and femoro-popliteal bypass. There were increases in plasma fibrinogen (P<0.01) and factor VIII coagulant (P<0.01) levels following all three procedures. There were decreases in antithromhin III (P<0.01) and protein C (P<0.01), and increases in thrombin-antithrombin complex levels (P<0.01) in the abdominal aortic group only. There were no significant changes in type 1 plasminogen activator inhibitor levels following any of the procedures. The results indicate that all three procedures are associated with an increased potential for thrombosis due to increases in procoagulant factors. However, patients undergoing abdominal aortic surgery are particularly at risk due to concurrent decreases in natural anticoagulant factors. Specific antithrombotic therapy should be considered for all patients undergoing vascular surgery, but particularly for those undergoing major procedures such as abdominal aortic surgery.

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The Effect of Low-Dose Heparin on Hypercoagulability following Abdominal Aortic Surgery

Anaesthesia and Intensive Care ◽

10.1177/0310057x9802600505 ◽

1998 ◽

Vol 26 (5) ◽

pp. 503-508 ◽

Cited By ~ 9

Author(s):

N. M. Gibbs ◽

R. Bell

Keyword(s):

Unfractionated Heparin ◽

Whole Blood ◽

Low Dose ◽

Aortic Surgery ◽

Abdominal Aortic Surgery ◽

Dose Heparin ◽

Abdominal Aortic ◽

Low Dose Heparin

The effect of low-dose heparin on postoperative hypercoagulability was assessed using thrombelastography (TEG) in eighteen patients undergoing elective abdominal aortic surgery. Patients received unfractionated heparin 50001U bd SC commencing on the first postoperative day. Native whole blood TEG was performed preoperatively and on day two postoperatively. A heparinase-modified TEG was performed at the same time as the native whole blood TEG on day two. There were no significant changes in the postoperative native whole blood TEG variables (r, K, α, MA) relative to preoperative controls. In contrast, there were significant decreases in r and K, and increases in a in the heparinase-modified TEGs postoperatively (P<0.01). There were significant differences between the postoperative native whole blood and heparinase-modified TEGs for all TEG variables (P<0.01). The results indicate that low-dose heparin reduces postoperative hypercoagulability following abdominal aortic surgery as assessed by thrombelastography.

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