Thrombosis

Thrombosis

• Thrombosis is the process of a blood clot, also known as a thrombus,

forming in a blood vessel
• It can block or obstruct blood ow in the a ected area, as well as cause
serious complications if the clot moves to a crucial part of the circulatory
system, such as the brain or the lungs

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 Thrombosis Types
Thrombosis can be broadly classi ed as either venous thrombosis or arterial thrombosis,
according to where the thrombus presents in the body.

Examples of categorising venous thrombosis include:

• Deep vein thrombosis

• Portal vein thrombosis

• Renal vein thrombosis

• Jugular vein thrombosis

• Budd-Chiari Syndrome

• Paget-Schoetter disease

• Cerebral venous sinus thrombosis

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 Artherothrombosis

• Arterial thrombosis, also known as atherothrombosis due to its association with

atheroma rupture, occurs in the arteries.
• The blood stasis caused by atrial brillation may also cause this type of thrombosis.
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 Stroke

• Results from poor blood ow to the brain

• There are multiple causes for stroke, including

ischemia, hemorrhage and embolus in the
brain
• Stroke due to a blood clot in the brain usually
builds gradually around an atherosclerotic
plaque.

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 Myocardial
• Occurs when blood ow decreases or stops to a
part of the heart, causing damage to the heart
muscle
• Myocardial infarction may also be caused by a
thrombus in the coronary artery and is
associated with ischemia
• This reduced oxygen supply to the heart cells,
as a result of the blockage, results in cell death
and myocardial infarction

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Thrombosis
 Endothelial injury

• Endothelial injury leads to platelet activation which causes thrombus formation

in the heart and the arterial circulation, and greatly increases clot formation.
• Notably, cardiac and arterial clots are typically rich in platelets, and it is believed
that platelet adherence and activation is a necessary prerequisite for thrombus
formation under high shear stress.
• Severe endothelial injury may trigger thrombosis by exposing VWF and tissue
factors.
• in ammation and other noxious stimuli also promote thrombosis
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 Abnormal Blood Flow

• Turbulence (chaotic body ow) contributes to arterial and cardiac thrombosis

by causing endothelial injury or dysfunction as well as by forming
countercurrents and local pockets of stasis.
• Stasis is a major factor in the development of venous thrombi
• Under conditions or normal laminar blood ow, platelets are found mainly in
the center of the vessel lumen, separated from the endothelium by a slower-
moving layer of plasma
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 Abnormal Blood Flow

By contrast, stasis and turbulence have the following deleterious e ects:

Both promote endothelial cell activation and enhanced procoagulant activity, in

part through ow-induced changes in endothelial gene expression.

Stasis allows platelets and leukocytes to come into contact with the
endothelium when the ow is sluggish.

Stasis also slows the washout of activated clotting factors and impedes the
in ow of clotting factors and impedes the in ow of clotting factor inhibitors.
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 Hypercoagulability

• Hypercoagulability refers to an
abnormally high tendency of the blood
to clot, and is typically caused by
alterations in coagulation factors
• Contributes infrequently to arterial or
intracardiac thrombosis but is an
important underlying risk factor for
venous thrombosis

 Complications

• Hypoxia, due to the obstruction of the artery of vein

• When the majority of the blood vessel is blocked, the oxygen supply to the body is
reduced and results in increased production of lactic acid.
• The blood clot may also break free and travel around the body, a process known as
embolization
• This can obstruct the blood ow to essential organs, such as the brain or the lungs,
reducing or inhibiting oxygen and blood ow with severe repercussions

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 Prevention and Treatment

• Movement, particularly if susceptible individuals are likely to be
sedentary for long periods of time, such as in bed or on an
airplane.
• People with high risk of venous thromboembolism, heparin can
be administered, this reduces risk of pulmonary embolism
• In order to pervent the formation of deep vein thrombosis is
the use of compression stockings, which mechanically support
the vein to inhibit the formation of blood clots.
• Anticoagulants may increase the risk of major bleeding slightly,
but has been found to o er a bene t in both the prevention
and treatment of thrombosis.

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 References

“Robbins Basic Pathology Book” Kumar Abbas Aster- (Elsevier)

https://natfonline.org/patients/what-is-thrombosis/

https://en.wikipedia.org/wiki/Thrombosis

https://www.mayoclinic.org/diseases-conditions/deep-vein-thrombosis/symptoms-
causes/syc-20352557