Thrombosis

THROMBOSIS

Thrombosis is the pathologic formation of an intravascular fibrin-platelet thrombus during life. Factors involved in thrombus formation (Virchow’s triad) include:

·            Endothelial injury due to atherosclerosis, vasculitis, or many other causes

·            Alterations in laminar blood flow predisposing for DIC occur with stasis of blood (e.g., immobilization); turbulence (e.g., aneurysms); and hyperviscosity of blood (e.g., polycythemia vera)

·              Hypercoagulability of blood can be seen with clotting disorders (factor V Leiden; deficiency of antithrombin III, protein C, or protein S); tissue injury (postoperative and trauma); neoplasia; nephrotic syndrome; advanced age; pregnancy; and oral contraceptives (estrogen increases synthetic activity of the liver, including clotting factors)

Common locations of thrombus formation include coronary and cerebral arteries; heart chambers in atrial fibrillation or post-MI (mural thrombus); aortic aneurysms; heart valves (vegetations); and deep leg veins (DVTs).

Outcomes of thrombosis include vascular occlusion and infarctions; embolism; thrombolysis; and organization and recanalization.