November 1972

The Behavior of Thrombi

Arch Surg. 1972;105(5):681-682. doi:10.1001/archsurg.1972.04180110006001

We teach medical students that a clot in the vascular system, that the blood does not wash away as an embolus, either dissolves or organizes. Also, if the clot organizes, it either undergoes recanalization resulting in multiple small channels or retracts so that reestablishment of the main channel occurs.

The above concept might pass an examination in medical school. But in the past 20 years, the growing sophistication of vascular surgeons and angiographers has demanded better answers to questions about causes, modifying influences (such as lytic forces), and timing. In spite of extensive experimental work, it is not possible at the present time to describe adequately the pathogenesis of thrombosis.

Let us review some clinical and experimental settings, but first, two definitions that may help communication. "Recanalization" will be used to define large endothelial-lined channels that form to allow functional reconstitution of blood flow; "canaliculization" to mean small endotheliallined channels,

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