HEMOSTASIS ACTIVATION DURING SCLEROTHERAPY OF LOWER-EXTREMITY VARICES

The influence of compression sclerotherapy upon hemostasis activation was investigated in 41 consecutive patients with lower extremity varic es by serial measurement of thrombin-antithrombin III complexes (TAT), D-dimer, fibrinogen and C-reactive protein (CRP). Blood sampling was carried out before operation and on the 7th and 28th post-operative da y in patients randomly assigned to either the control group (n=18), in which high ligation of sapheno-femoral junction and local excision of varices were performed, or the sclerotherapy group (n=23) in which th e comparable surgical intervention and compression sclerotherapy using hypertonic saline were performed simultaneously. In both groups, the TAT, D-dimer and fibrinogen concentrations at day 7 were significantly elevated compared to the value before operation while CRP showed no s ignificant change during the observation period. In the sclerotherapy group, higher incidence of superficial thrombosis was observed and the TAT concentration at day 7 was significantly higher than that in the control group (p<0.01), and the TAT at day 28 was still significantly elevated compared to the pre-operative level (p<0.05). However, no rel ationship between TAT and D-dimer concentrations and the extent of sup erficial thrombosis was observed. We conclude that compression sclerot herapy for lower extremity varices causes latent activation of coagula tion system and can be a risk factor for venous thromboembolism.