Thrombosis

Thrombosis refers to the formation of solid intravascular clot. It can be considered as a pathological extension of normal haemostasis. The steps in thrombus formation include: Endothelial cell damage with the exposure of subendothelial collagen Platelet plug formation;

Activation of the intrinsic coagulation cascade; Formation of fibrin; Entrapment of blood cells;

This is followed by granulation tissue formation, recanalisation and scar formation.

Virchow's triad enumerates the pathogenetic mechanisms in thrombus formation. The triad comprises: Changes in blood flow pattern Reduced speed of flow: General: (e.g., congestive heart failure) Local: prolonged limb dependence reduced muscle pump activity proximal occlusion of venous drainage

E Turbulence:

o d Arterial branch points

Narrowed arterial segments

Changes in vessel wall intimai surface Atheroma

Injury to endothelium: mechanical/chemical

Inflammation

Neoplastic invasion

Changes in blood constituents

Increase in circulating platelets

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