Factor V Leiden can complicate risk of clot after surgery

Dear Dr. Roach: My husband had surgery. A couple of days later he was diagnosed with a blood clot in his calf. They did blood testing on him, and one test came back positive for “one copy of the Factor V Leiden Variant.” He was put on 5 milligrams of Eliquis twice a day. We were told to have our children checked and two have tested positive. They were told to make their doctors aware prior to surgery and during long periods of sitting to get some exercise.

We are wondering if my husband, who is in his 80s, still needs to take the Eliquis daily. Is this a condition that necessitates blood thinners? — G.B.

Dear G.B.: Blood clots are common around surgery, and there is much advice on how best to prevent them.

The main risk of a blood clot is it can break off and go to the lungs. This is called a pulmonary embolism. Medication can reduce risk. For a person who had a blood clot around the time of surgery, the usual duration of treatment with medicine is three months.

Factor V Leiden is a common genetic variant of one of the blood clotting proteins. There are two copies of factor V. Your husband has one normal copy and one variant copy. This does not alter the recommendations for duration of anticoagulation. He might need medication to prevent a recurrent clot after future surgeries. A person with a history of blood clots is at higher risk for another.

You should ask his doctor or hematologist, because there may be additional factors that made them want to continue.

Your children should also be cautious during times of long travel. Tell them to frequently walk around, stretch their legs and stay hydrated.