Summary
Current biochemical markers of thrombosis, such as d-dimer, are of little value in
demonstrating the presence of thrombus postoperatively, as their levels are elevated
by surgery. Thrombosis involves adhesive interactions between the endothelium, platelets
and leukocytes. The aim of the study was to determine which of a panel of haemostatic
and adhesion factors are altered by the presence of thrombus, but not by surgery.
These factors were measured in 20 patients with established spontaneous DVTs, 13 patients
having hip replacement surgery and 28 control patients. Circulating levels of P-selectin,
VCAM-1 and tissue factor were found to be increased when thrombus was present (p <0.018,
p <0.0001, p <0.0028 respectively), but were not altered by surgery. The significance
of these circulating factors in venous thrombosis remains to be established, but it
is conceivable that they are the product of increased leukocyte trafficking and activity.
Assay of VCAM-1, in particular, may be of use in the early detection of venous thrombi
in postoperative patients.
Key Words
Deep vein thrombosis