Document Detail


The aetiology of deep venous thrombosis.
MedLine Citation:
PMID:  16905749     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Most ideas about the pathogenesis of deep venous thrombosis (DVT) are dominated by a 'consensus model' first articulated around 1962. This model invokes 'Virchow's triad' and attributes thrombogenesis in veins to some combination of 'hypercoagulability', 'stasis' and 'intimal injury'. This arose as a by-product of studies on the mechanisms of haemostasis and bleeding diatheses that were at best only indirectly relevant to thrombosis, and there are reasons for doubting the causal significance of 'hypercoagulability' and 'stasis' in the aetiology of DVT. Proponents of the consensus model make little reference to a substantial literature, mostly historical, that: (a) emphasizes the significance of the venous valve pockets (VVP) and blood rheology in DVT pathogenesis; and (b) describes morphological features specific to venous thrombi that a valid aetiological model must explain. This literature provides the basis for an alternative hypothesis of DVT aetiology, published some 30 years ago, which has been experimentally corroborated and is compatible with recent cell and molecular biological studies of the venous endothelium. We review this alternative hypothesis, considering its potential value for future research on DVT and embolism, and its significance for clinical practice.
Authors:
P C Malone; P S Agutter
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Publication Detail:
Type:  Journal Article; Review     Date:  2006-08-12
Journal Detail:
Title:  QJM : monthly journal of the Association of Physicians     Volume:  99     ISSN:  1460-2725     ISO Abbreviation:  QJM     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-25     Completed Date:  2007-03-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9438285     Medline TA:  QJM     Country:  England    
Other Details:
Languages:  eng     Pagination:  581-93     Citation Subset:  IM    
Affiliation:
Theoretical and Cell Biology Consultancy, 26 Castle Hill, Glossop, Derbyshire, USA.
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MeSH Terms
Descriptor/Qualifier:
Blood Coagulation Disorders / complications
Blood Flow Velocity / physiology
Endothelium, Vascular / pathology,  physiopathology
Humans
Models, Biological
Risk Factors
Veins / pathology,  physiopathology
Venous Thrombosis / etiology*,  physiopathology

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