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
Rudolf Virchow noted several factors affecting the clot formation, which are:
- Alterations in blood flow (stasis)
- Injury to the vascular endothelium
- Alterations in the constitution of blood (hypercoagulability)
These are collectively known as Virchow's triad.
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)
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.