Arterial and venous thrombosis differences and similarities

Associate Editors-in-Chief: Ujjwal Rastogi, MBBS [mailto:urastogi@perfuse.org]

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. Furthermore certain studies have indicated the role of platelet in Venous thrombosis. 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.
 * 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.