Hematology and Oncology
Thrombosis occurs when a blood clot forms within a blood vessel, either venous or arterial, restricting the normal flow of blood and causing health manifestations.
Acute venous and arterial thrombosis are the most prevalent causes of mortality in wealthy nations. Mortality varies according to the site and severity of the thrombosis, with myocardial injury and brain hemorrhage or stroke responsible for the majority of thrombosis-related deaths.
It can be due to multiple factors such as:
Arterial thrombosis can be induced by arteriosclerosis, which is the stiffening of the vessels. This occurs if fatty or calcium particles clog the arterial lining. This can cause fatty material to build up in the arterial walls. This plaque has the potential to pop, resulting in a blood clot.
The epidemiology differs based on whether the thrombosis is venous or arterial, provoked or spontaneous, and if it is the very first recurrent bout. The yearly incidence of venous thromboembolism, which comprises deep vein thrombosis and pulmonary embolism, is one per ten thousand at childbearing age and one per hundred at old age. According to research, people of European ancestry have a higher risk of venous thrombosis than non-European origin.
The following are some of the risk factors for venous thrombosis:
The following are some of the risk factors for arterial thrombosis:
The clinical signs of thrombosis differ based on the suspected site and severity of the thrombosis.
The sort of imaging method utilized will be determined by the type of thrombus you have and its location.MRI, MRA, or CT scans are all options.
Modified Wells' criteria: Whenever patients arrive at the emergency room with clinical manifestations that imply venous thrombosis, a scale called the modified Wells' criteria is used to direct additional diagnostic testing.
D-dimer: A serum D-dimer test must be performed on patients with a high Wells score. Its increase may be used to identify venous thrombosis and is quite sensitive. A negative D-dimer test assists in ruling out the diagnosis and avoiding costly imaging investigations or anticoagulant therapy.
Duplex US: It is a scan of the lower or upper limbs used to check for DVT.
A CT angiogram and ventilation/perfusion scanning (V/Q scan): These are suggested imaging techniques for pulmonary embolism.
Hypercoagulable workup: A focused hypercoagulable workup might be needed in individuals suspected of carrying an underlying genetic thrombophilia. These tests include protein C and S, antithrombin III, and factor V Leiden or Prothrombin gene mutations.
Cancer screening: All individuals should have age-appropriate cancer screening.
Management for thrombosis is determined by whether the thrombosis is in a venous or an arterial territory, the patient's health, and the likelihood of medication consequences.
Anticoagulants: Anticoagulants, often called blood thinners, are chemical agents that inhibit or diminish blood coagulation, lengthening the time it takes for blood to clot. Anticoagulants such as warfarin and vitamin K antagonists can be given orally to minimize the risk of thromboembolism. Heparin can also be administered concurrently if a more robust reaction is necessary. Because any anticoagulant carries the likelihood of bleeding as an adverse reaction, the international normalized ratio (INR) of blood is measured routinely.
Thrombolysis: Thrombolysis is the medical demolition of clots by providing thrombolytic medications, such as recombinant tissue plasminogen activator, that boost the body's natural enzymes' ability to destroy clots.
Antiplatelets: Because a high proportion of platelets characterizes arterial thrombosis, inhibiting platelet activation with antiplatelet medicines like aspirin may minimize the risk of relapse or advancement.
When arterial thrombosis produces acute limb ischemia, surgery may be required. To expand the problematic arteries, thin catheters are inserted. However, sometimes the doctor may recommend stent placement. A stent is a wire mesh tube that keeps a blood vessel open and prevents it from shutting down.
The prognosis for thrombosis depends on the kind of thrombosis, the site of the thrombosis, the intensity of the thrombosis, the retention of precipitating risk factors and morbidities, and whether the thrombosis is the first or successive episode. Recurrent VTE is more common among patients with venous thrombosis than in the general population, especially with baseline triggering health risks.
Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 31, 2023.
What is Thrombosis? | North American Thrombosis Forum
Thrombosis | Johns Hopkins Medicine