Venous thromboembolism pathophysiology

Editors-in-Chief: C. Michael Gibson, M.S., M.D. Associate Editor-In-Chief: Ujjwal Rastogi, MBBS [mailto:urastogi@perfuse.org]

Overview
In in the 19th and 20th centuries, researchers articulated three contributing factors to thrombosis: thrombophilia, hemodynamic changes, and endothelial injury/dysfunction.

Virchow's Triad

 * Virchow's triad describes the three broad categories of factors that are thought to contribute to thrombosis.
 * Thrombophilia
 * Hemodynamics changes (stasis, turbulence)
 * Endothelial injury/dysfunction


 * Virchow's triad is named after 19th century German physician Rudolf Virchow.
 * The elements comprising Virchow's triad were neither proposed by Virchow, nor did he ever suggest a triad to describe the pathogenesis of venous thrombosis. In fact, it was decades following Virchow's death before a consensus was reached proposing that thrombosis is the result of one of three criteria:
 * Alterations in blood flow
 * Vascular endothelial injury
 * Alterations in the constitution of the blood


 * Virchow's triad remains a useful concept for clinicians and pathologists alike in understanding the contributors to venous, and perhaps arterial, thrombosis. While the triad is now frequently applied to describe thrombosis arising within the arterial circulation, many continue to restrict it to that occurring within the venous vasculature.

The Triad
The triad consists of three components:

While both Virchow's and the modern triads describe thrombosis, Virchow's triad has been characterized as the consequences of thrombosis, and the modern triad as the causes of thrombosis.

Related Chapters

 * Venous thromboembolism: Under-recognized and under-treated
 * Deep vein thrombosis
 * Pulmonary embolism
 * Thrombosis
 * Nephrotic syndrome and risk of venous and arterial thromboembolism