A COMPARISON OF POSTOPERATIVE THROMBOTIC POTENTIAL FOLLOWING ABDOMINAL AORTIC-SURGERY, CAROTID ENDARTERECTOMY, AND FEMOROPOPLITEAL BYPASS

Postoperative changes in procoagulant, anticoagulant, and antifibrinol ytic factors were compared in patients undergoing abdominal aortic sur gery, 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 an tithrombin III (P<0.01) and protein C (P<0.01), and increases in throm bin-antithrombin complex levels (P<0.01) in the abdominal aortic group only, There were no significant changes in type I plasminogen activat or inhibitor levels following any of the procedures. The results indic ate that all three procedures are associated with an increased potenti al for thrombosis due to increases in procoagulant factors. However pa tients undergoing abdominal aortic surgery are particularly at risk du e to concurrent decreases in natural anticoagulant factors. Specific a ntithrombotic therapy should be considered for all patients undergoing vascular surgery but particularly for those undergoing major procedur es such as abdominal aortic surgery.