Peripheral vascular disease and Virchow's triad for thrombogenesis.

نویسندگان

  • A Makin
  • S H Silverman
  • G Y H Lip
چکیده

Peripheral vascular disease (PVD), with its symptomatic manifestation, intermittent claudication, is associated with significant morbidity and mortality, and is an important cause of clinic visits and hospitalizations. Many patients with PVD sustain cardiovascular complications, such as heart attacks and strokes, which represent the main causes of death in this condition, rather than PVD per se. Further, emergency treatment is commonly required in this condition due to thrombosis of the affected artery. Indeed, the ‘costs’ of peripheral artery occlusion resulting in critical leg ischaemia have been estimated at $500–1000 per million per year, with a mortality of about 20% per year in these patients. While it would be convenient to treat PVD as a single entity, this is not the case, as several almost distinct processes can be identified. The development of the atherosclerotic plaque is the obvious initial process, eventually progressing in severity and leading to intermittent claudication. The next is the progression to critical ischaemia, with rest pain and gangrene. The basic underlying pathophysiological processes underlying these major complications of PVD are thrombosis and atherogenesis. However, simply suggesting that these events are solely due to the exposure of the blood to the thrombogenic surface of the ruptured plaque, as is the case in coronary artery disease, may be simplistic. Closer examination suggests that thromboembolism, disease progression and the effect(s) of intervention (or failure of the latter) in PVD can be explained by careful reference to Virchow’s triad for thrombogenesis.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Virchow's triad revisited: blood constituents.

An update of Virchow's triad for thrombogenesis can be considered by reference to abnormalities in the endothelium/endocardium ('abnormal vessel wall'), abnormalities of haemorhelogy and turbulence at bifurcations,atheroma at vessel wall ('abnormal bloodflow') and abnormalities in platelet as well as the coagulation and fibrinolytic pathways ('abnormal blood constituents'). The constituents of ...

متن کامل

Behçet’s Disease as a Model of Venous Thrombosis

Behçet's disease (BD) is a chronic inflammatory disease of unknown aetiology characterized by recurrent oral, genital aphthous ulcerations, uveitis, skin lesions and other multisystem affections associated with vasculitis. Different types of vessels, predominantly veins, can be affected in BD. The frequency of vascular lesions in BD, such as superficial and deep venous thromboses, arterial aneu...

متن کامل

Electrical muscle stimulation in thomboprophylaxis: review and a derived hypothesis about thrombogenesis—the 4th factor

INTRODUCTION Electrical muscle stimulation (EMS) is an FDA-approved thromboprophylactic method. Thrombus pathogenesis is considered to depend on factors related to components of the vessel wall, the velocity of blood, and blood consistency-collectively known as, the Virchow's triad. OBJECTIVE The testimony supporting the thromboprophylactic effects of the EMS is reviewed. An emphasis is place...

متن کامل

Procoagulant activity in hemostasis and thrombosis: Virchow's triad revisited.

Virchow's triad is traditionally invoked to explain pathophysiologic mechanisms leading to thrombosis, alleging concerted roles for abnormalities in blood composition, vessel wall components, and blood flow in the development of arterial and venous thrombosis. Given the tissue-specific bleeding observed in hemophilia patients, it may be instructive to consider the principles of Virchow's triad ...

متن کامل

Does heart failure confer a hypercoagulable state? Virchow's triad revisited.

It is well-recognized that patients with congestive heart failure are at an increased risk of stroke and venous thromboembolism. Nevertheless, stroke, thromboembolism and myocardial infarction have generally been regarded to be end points of secondary importance in large heart failure trials, when compared with mortality or hospital readmissions. It may well have been that the incidence of thro...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • QJM : monthly journal of the Association of Physicians

دوره 95 4  شماره 

صفحات  -

تاریخ انتشار 2002