Thromboembolism classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Classification
Classification for Thrombus Based on Vessel Type
There are two distinct forms of thrombosis:
Venous Thrombosis
- Deep venous thrombosis (with or without pulmonary embolism; together classified as venous thromboembolism/VTE)
- Portal vein thrombosis
- Renal vein thrombosis
- hepatic vein thrombosis (Budd-Chiari syndrome)
- Paget-Schroetter disease
- Cerebral venous sinus thrombosis
- Thoracic outlet syndrome (the cause of most Subclavian vein thrombosis unrelated to trauma)
Arterial Thrombosis
Classification of Embolism Based on Direction of Blood Flow
If a bacterial infection is present at the site of thrombosis, the thrombus may break down, spreading particles of infected material throughout the circulatory system (pyemia, septic embolus) and setting up metastatic abscesses wherever they come to rest.
Without an infection, the thrombus may become detached and enter circulation as an embolus, finally lodging in and completely obstructing a blood vessel (an infarction). The effects of an infarction depend on where it occurs.
The pathway of the embolism can be one of three types:
- Anterograde
- Retrograde
- Paradoxical
In anterograde embolism, the movement of emboli is in the direction of blood flow. In retrograde embolism, however, the emboli move in opposition to the blood flow direction; this is usually significant only in blood vessels with low pressure (veins) or with emboli of high weight. In paradoxical embolism, also known as crossed embolism, an embolus from the veins crosses to the arterial blood system. This is generally found only with heart problems such as septal defects between the atria or ventricles.
Sources of Systemic Embolism
- Left ventricular thrombus
- Left atrial thrombus
- Pelvic veins or lower extremity thrombus
- Native cardiac valves
- Prosthetic cardiac valves
- Cardiac tumors
- Aortic aneurysm
- Invasive manipulations
- Left ventricular aneurysm
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Sources of Systemic Embolism: Large left ventricular thrombus in a patient with myocardial infarction -
Sources of Systemic Embolism: Large left ventricular thrombus in a patient with myocardial infarction
