Deep vein thrombosis pathophysiology
Editors-in-Chief: C. Michael Gibson, M.S., M.D. Associate Editor-In-Chief: Ujjwal Rastogi, MBBS [1]
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Pathophysiology
Factors which affect the clot formation are:
- rate of flow
- the consistency (thickness) of the blood
- qualities of the vessel wall.
These are known as Virchow's triad.
Virchow noted that more deep venous thrombosis occurred in the left leg than in the right and proposed compression of the left common iliac vein by the overlying right common iliac artery as the underlying cause (see May-Thurner syndrome)
The most common risk factors are recent surgery or hospitalization. [2] 40% of these patients did not receive heparin prophylaxis. Other risk factors include
- advanced age
- obesity
- infection
- immobilization and air travel ("economy class syndrome", a combination of immobility and relative dehydration)
- Female sex
- Use of combined (estrogen-containing) forms of hormonal contraception
- Tobacco usage
are some of the better-known causes [3]
Thrombophilia (tendency to develop thrombosis) often expresses itself with recurrent thromboses.
It is recognized that thrombi usually develop first in the calf veins, "growing" in the direction of flow of the vein. DVTs are distinguished as being above or below the popliteal vein. Very extensive DVTs can extend into the iliac veins or the inferior vena cava. The risk of pulmonary embolism is higher in the presence of more extensive clots.