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Vascular Medicine and Endovascular Interventions - part 3

Huyết khối triệu chứng gây ra bởi dysregulation cầm máu bình thường để tàu "thương tích" bức tường đó xảy ra với tiếp xúc với một yếu tố nguy cơ lâm sàng (ví dụ, phẫu thuật, chấn thương, hoặc nhập viện cho bệnh y tế cấp). Tàu bức tường bị tổn thương có thể được giải phẫu | 5 Thrombophilia John A. Heit MD Introduction Symptomatic thrombosis is caused by dysregulation of the normal hemostatic response to vessel wall injury that occurs with exposure to a clinical risk factor e.g. surgery trauma or hospitalization for acute medical illness . Vessel wall injury may be anatomic e.g. venous endothelial microtears within vein valve cusps due to stasis or rupture of a lipid-rich atherosclerotic plaque or non-anatomic e.g. cytokine-mediated endothelial expression of adhesion molecules or downregulation of thrombomodulin expression related to the acute inflammatory response . However the vast majority of persons exposed to a clinical risk factor do not have development of symptomatic thrombosis. We now recognize that clinical thrombosis is a multifactorial and complex disease that becomes manifest when a person with an underlying predisposition to thrombosis thrombophilia s is exposed to additional risk factors. Emerging evidence suggests that individual variation in the regulation of the procoagulant anticoagulant fibrinolytic and acute inflammation or innate immunity pathways most likely accounts for the development of clinical thrombosis in exposed persons. Thrombophilia is defined as a predisposition to thrombosis. Thrombophilia is not a disease per se but may be associated with a disease e.g. cancer with drug exposure e.g. oral contraceptives or with a specific condition e.g. pregnancy or post partum acquired thrombophilia Portions of this manuscript have been previously published in Heit JA. Venous thromboembolism disease burden outcomes and risk factors. J Thromb Haemost. 2005 3 1611-7. Used with permission. Supported in part by research grants HL66216 HL83141 HL83797 and RR19457 from the National Institutes of Health and research grant TS1255 from the Centers for Disease Control and Prevention United States Public Health Service and by Mayo Foundation. 2007 Society for Vascular Medicine and Biology Table 5.1 thrombophilia may also be .