THE COAGULOFIBRINOLYTIC STATE OF PATIENTS WITH PRIMARY VARICOSE-VEINSOF THE LOWER LEGS

The relationship between a local hypercoagulable state and primary var icose veins of the lower legs was investigated by measuring the plasma levels of D-dimer (DD) and the thrombin-antithrombin-III complex (TAT ) in 122 consecutive patients before treatment, and in 46 patients aft er surgical intervention and compression sclerotherapy, Elevated level s of DD and TAT were found in 25% and 20%, respectively, of the 122 pa tients, being significantly elevated in the patients with thrombophleb itis compared to the patients with no dermal symptoms, pigmentation, o r stasis dermatitis. There was no significant difference in either par ameter among eight groups of patients classified according to their va lvular incompetence, The levels of DD and TAT were elevated before tre atment in 25% and 20%, respectively, of 45 treated patients, but becam e significantly reduced after treatment, These results indicate that e ven though the local hypercoagulable state in varicose veins without t hrombophlebitis is too subtle to be detected by systemic parameters su ch as DD and TAT, a local hypercoagulable state can be detected in a c ertain proportion of patients with venous stasis by these parameters.