Majluf-Cruz A, Espinosa-Larrañaga F

Language: Spanish
References: 28
Page: 11-14
PDF size: 45.21 Kb.

ABSTRACT

A blood cloth represents a homeostatic response however, a blood thrombous is always a pathological phenomenon that may be generated in arteries, veins, capillaries or in the heart. The thrombous may obstruct the blood flow inducing tissue- and cell ischemia. It is formed by a network containing fibrin and platelets that include other blood elements. Complications associated to a thrombosis are also due to embolization of the thrombotic material. A venous embolus moves through the vein system from stretch to widest veins as it reaches the heart. Once it passes from the right cardiac cavities to a pulmonary artery it stops at the lung vasculature. Based on this pathophysiological explanation, venous thromboembolic disease (VTD) is the most appropriate term to define this clinical entity. Thrombophilia is a specific state of the blood coagulation system in which resistance to thrombosis is diminished. Virchow postulated that three specific situations predispose to VTD: disorders of the vascular wall; changes in the blood flow; and abnormalities in the components of the blood. Abnormalities in some of these components induce a prothrombotic state. Immobilization is almost always present. Patients at the highest risk for VTD disease have abdominal or leg trauma, history of VTD, venous insufficiency, advanced age, obesity, cancer, pregnancy, blood group O, cardiac insufficiency or they are under hormonal therapy. Since multiple simultaneous thrombophilias are required to generate thrombosis it can be stated that this is a polygenic phenomenon in which hereditary and acquired factors are participating. In all patients suffering a thrombotic event multiple thrombophilias are interacting simultaneously. Therefore, thrombotic risk of every patient must be individually evaluated based on all prothrombotic factors present in order to indicate the most appropriate thromboprophylaxis.

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