Arterial thrombosis associated with heterozygous factor V Leiden disorder, hyperhomocysteinemia, and peripheral arterial disease: importance of synergistic factors

J Vasc Surg. 2005 Nov;42(5):1014-8. doi: 10.1016/j.jvs.2005.06.019.

Abstract

A 47-year-old man with heterozygous factor V Leiden disorder and intermittent hyperhomocysteinemia developed spontaneous acute popliteal artery thrombosis. Homocysteine levels were above normal limits at presentation. Intra-arterial thrombolysis was used successfully to treat the acute thrombosis; long-term treatment included anticoagulation, folic acid, and risk factor modification. Although factor V Leiden is strongly associated with deep venous thrombosis, additional cofactors such as hyperhomocysteinemia may predispose to an increased risk of acute arterial thrombosis in areas of pre-existing peripheral arterial disease.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Angiography
  • Factor V / genetics
  • Factor V Deficiency / blood
  • Factor V Deficiency / complications*
  • Factor V Deficiency / genetics
  • Fibrinolytic Agents / administration & dosage
  • Fibrinolytic Agents / therapeutic use
  • Follow-Up Studies
  • Heparin / administration & dosage
  • Heparin / therapeutic use
  • Heterozygote
  • Humans
  • Hyperhomocysteinemia / blood
  • Hyperhomocysteinemia / complications*
  • Injections, Intra-Arterial
  • Male
  • Middle Aged
  • Mutation
  • Peripheral Vascular Diseases / complications*
  • Popliteal Artery*
  • Thromboembolism / diagnostic imaging
  • Thromboembolism / drug therapy
  • Thromboembolism / etiology*
  • Thrombolytic Therapy
  • Tissue Plasminogen Activator / administration & dosage
  • Tissue Plasminogen Activator / therapeutic use

Substances

  • Fibrinolytic Agents
  • Factor V
  • Heparin
  • Tissue Plasminogen Activator