Arterial and venous thrombosis differences and similarities: Difference between revisions
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==Differences== | ==Differences== | ||
Arterial thrombosis occur at places of arterial plaque rupture where the shear rate is higher, in contrast | Arterial thrombosis occur at places of arterial plaque rupture where the shear rate is higher, in contrast vein thrombosis occur at places where the vein wall is normal and blood flow and shear rate is low. | ||
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| Inherit property of the vessel | | Inherit property of the vessel | ||
| Firm, thick walled, | | Firm, thick walled, high pressure and rapid flow | ||
| Floppy, thin walled, | | Floppy, thin walled, low pressure and slow flow. | ||
|- | |- | ||
| Location of the thrombus formation | | Location of the thrombus formation | ||
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| Complication | | Complication | ||
| More chances of distal thrombosis | | More chances of distal thrombosis | ||
| Can cause [[ | | Can cause [[pulmonary embolism]] | ||
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| Approach to treatment | | Approach to treatment | ||
| Risk factor modification (eg, smoking cessation, | | Risk factor modification (eg, smoking cessation, diabetes control, obesity management) plus anti-platelet drugs | ||
| Prophylaxis against venous stasis and blood thinners. | | Prophylaxis against venous stasis and blood thinners. | ||
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Revision as of 19:05, 27 February 2013
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Thrombosis Microchapters |
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Site of Thrombosis |
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Differentiating Thrombosis from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
More than a century ago, Virchow postulated that a triad of conditions (later called virchow's triad) leads to thrombus formation. Venous thrombosis has been associated with red blood cell and fibrin rich red clot while arterial thrombosis occur on atherosclerotic lesions with active inflammation, and are rich in platelets and give an appearance of white clot.[1] Furthermore certain studies have indicated the role of platelet in Venous thrombosis.[2] Thus, traditionally, venous thrombosis and arterial thrombosis has been described as distinct diseases with different risk factors, pathology and treatment. However, recent studies have shown an association between them.
Similarities
The two vascular complications, venous and arterial thrombosis, share many risk factors such as:
- Obesity
- Hypertension
- Tobacco use
- Dyslipidemia
- Diabetes mellitus
- Metabolic syndrome
- Diet
- Age
- Hormonal replacement/contraceptive therapy
Furthermore there are many diseases that causes both arterial and venous thrombosis, such as:
- Antiphospholipid antibody syndrome
- Hyperhomocysteinemia
- Malignancies
- Infections
- Nephrotic syndrome[3]
- Hormonal treatment
- Bechet's disease
- Poplitial artery aneurysm (Large aneurysm can compress the poplitial vein and cause DVT)
Differences
Arterial thrombosis occur at places of arterial plaque rupture where the shear rate is higher, in contrast vein thrombosis occur at places where the vein wall is normal and blood flow and shear rate is low.
| Parameter | Arterial | Venous |
|---|---|---|
| Inherit property of the vessel | Firm, thick walled, high pressure and rapid flow | Floppy, thin walled, low pressure and slow flow. |
| Location of the thrombus formation | Arterial plaque rupture | Normal vein wall |
| Duration from initial insult to thrombus formation | takes a long time, often decades to happen | occur rapidly |
| Shear rate | high | low |
| Microscopic appearance of clot | Excess platelet and less fibrin, thus called White clot | Less platelet and more fibrin, thus termed Red clot |
| Complication | More chances of distal thrombosis | Can cause pulmonary embolism |
| Approach to treatment | Risk factor modification (eg, smoking cessation, diabetes control, obesity management) plus anti-platelet drugs | Prophylaxis against venous stasis and blood thinners. |
| Example | MI, Stroke, Peripheral artery diseases | Deep vein thrombosis |
References
- ↑ Jerjes-Sanchez C (2005). "Venous and arterial thrombosis: a continuous spectrum of the same disease?". Eur Heart J. 26 (1): 3–4. doi:10.1093/eurheartj/ehi041. PMID 15615791.
- ↑ Sobieszczyk P, Fishbein MC, Goldhaber SZ (2002). "Acute pulmonary embolism: don't ignore the platelet". Circulation. 106 (14): 1748–9. PMID 12356622.
- ↑ Mahmoodi BK, ten Kate MK, Waanders F, Veeger NJ, Brouwer JL, Vogt L; et al. (2008). "High absolute risks and predictors of venous and arterial thromboembolic events in patients with nephrotic syndrome: results from a large retrospective cohort study". Circulation. 117 (2): 224–30. doi:10.1161/CIRCULATIONAHA.107.716951. PMID 18158362.