International Journal of Angiology

, Volume 4, Issue 2, pp 99–102 | Cite as

Thrombotic disorders of hemostasis in patients with deep vein thrombosis

  • Gernold Wozniak
  • Heinrich Montag
  • José Alemany
Original Articles


For 22 months we investigated the hemostatic status of 93 inpatients (44 male, and 49 female, average age 54.6 years) with a phlebographically objectified deep venous thrombosis of the leg or iliac veins. Corresponding blood samples were taken before, during, and after therapy. In 58 (62.4%) patients we found several kinds of disorders of hemostasis. There were deficiencies of the protein C, protein S, factor XII, antithrombin III, and the thrombocytes function. In most cases there was a single acquired deficiency of one of these factors. Only in one patient (1.07%) could we verify an inherited deficiency of factor XII. The most frequent disorder was a protein C deficiency in 32 (34.4%) patients. In 44 (47%) operatively treated patients we had postoperative complications such as rethrombosis, phlegmasia coerulea dolens, or development of skin necrosis during anticoagulant therapy in 12 (27.3%) cases. In 10 (83%) of these patients with complications we had found preoperatively a disorder of hemostasis. The statistical correlation between a preoperatively measured deficiency of the protein C and the relapse of deep vein thrombosis was significant (p=0.0026).


Public Health Blood Sample Postoperative Complication Deep Vein Thrombosis Venous Thrombosis 
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  1. 1.
    Alemany J, Montag H, Wozniak G (1993) Rezidivthrombosen nach chirurgischer Thrombektomie ilio-femoraler Thrombosen. Angio Archiv Bd 24:147–150.Google Scholar
  2. 2.
    Wozniak G, Montag H, Alemany J (1992) Das erweiterte Gerinnungs-Screening—Eine Notwendigkeit in der Diagnostik und Therapie der Thrombose? VASA (suppl) 35:92–93.Google Scholar
  3. 3.
    Bauer KA, Rosenberg RD (1991) The hypercoagulable state. In: Disorders of Hemostasis, Ratnoff OD, Forbes CD (eds). W.B. Saunders: Philadelphia, pp 267–291.Google Scholar
  4. 4.
    Heeb MJ, Mosher D, Griffin JH (1989) Activation and complexation of protein C and cleavage and decrease of protein S in plasma of patients with disseminated intravascular coagulation. Blood 73:455–461.PubMedGoogle Scholar
  5. 5.
    Pui CH, Chesney CM, Bergum PW, et al (1986) Lack of pathogenetic role of protein C and S in thrombosis associated with asparaginase-prednisolon-vincristine therapy for leukaemia. Br J Haematol 64:283–290.PubMedGoogle Scholar
  6. 6.
    Zauber NP, Stark MW (1986) Successful warfarin anticoagulation despite protein C deficiency and a history of warfarin necrosis. Ann Intern Med 104:659–660.PubMedGoogle Scholar
  7. 7.
    Bovill EG, Bauer KA, Dickerman JD, et al (1989) The clinical spectrum of heterozygous protein C deficiency in a larger New England kindred. Blood 73:712–717.PubMedGoogle Scholar
  8. 8.
    Comp PC, Nixon R, Cooper R, Esmon CT (1984) Familial protein S deficiency is associated with recurrent thrombosis. J Clin Invest 74:2082–2088.PubMedGoogle Scholar
  9. 9.
    Griffin JH, Evatt B, Zimmermann TS, et al (1981) Deficiency of protein C in congenital thrombotic disease. J Clin Invest 68:1370–1373.PubMedGoogle Scholar
  10. 10.
    McGehee WG, Klotz TA, Epstein DJ, Rapaport SI (1984) Coumarin necrosis associated with hereditary protein C deficiency. Ann Intern Med 100:59–60.PubMedGoogle Scholar
  11. 11.
    Yuen P, Cheung A, Lin HJ, et al (1986) Purpura fulminans in a Chinese boy with congenital protein C deficiency. Pediatrics 77:670–676.PubMedGoogle Scholar
  12. 12.
    Comp PC, Esmon CT (1984) Recurrent venous thromboembolism in patients with a partial deficiency of protein S. N Engl J Med 311:1525–1528.PubMedGoogle Scholar
  13. 13.
    Rudofsky G, Timmermann J (1993) Lokoregionale Thrombolysetherapie tiefer venöser Thrombosen. Z Kardiol 82(suppl 2):61–63.PubMedGoogle Scholar
  14. 14.
    Fisher RA (1934) Statistical methods for research workers. Oliver and Boyd: London.Google Scholar
  15. 15.
    Harms V (1982) Biomathematik, Statistik und Dokumentation. Harms Verlag: Kiel.Google Scholar
  16. 16.
    Mammen EF, Barnhart MI, Selik NR, et al (1988) “Sticky Platelet Syndrom”: A congenital platelet abnormality predisposing to thrombosis? Folia Haematol 115(Leipzig):361–365.Google Scholar
  17. 17.
    Broekmans AW, Bertina RM, Loeliger EA, et al (1983) Protein C and the development of skin necrosis during anticoagulant therapy (Letter). Thromb Haemost 49:244.Google Scholar
  18. 18.
    Mannucci PM, Vigano S (1982) Deficiencies of protein C, an inhibitor of blood coagulation. Lancet 2:463–467.PubMedGoogle Scholar
  19. 19.
    Ucida K (1992) Influence of antibiotics on vitamin K metabolism. Ann Hematol 64(suppl):53.Google Scholar

Copyright information

© International College of Angiology, Inc. 1995

Authors and Affiliations

  • Gernold Wozniak
    • 1
  • Heinrich Montag
    • 1
  • José Alemany
    • 1
  1. 1.Department ofVascular SurgeryKnappschafts-KrankenhausBottropGermany

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