Arterial Thrombosis as a Consequence of 'Quasi-Chaotic' Coordination of Mechanical and Chemical Events

Abstract

Contrary to a popular notion, thrombosis is neither associated with 'stasis' nor with low-shear flow or turbulence. Instead, a regular eddy formation or flow separation as universal condition favoring thrombotic events is the fluid-dynamic anomaly initiating thrombotic events. Flow is discussed in terms of modern nonlinear fluid dynamics and is appreciated as a highly deterministic event ('low dimensional turbulence'). Moreover, with respect to the biochemistry and cytology of white thrombus formation, transient or permanent flow separation provides ideal conditions for the manifestation of self-organized procoagulatory reactions: these have marked positive feedback. The holistic reaction can be taken as a combination of deterministic yet stochastic events. Rather than calling such an event chaotic, it is proposed to accept it as a consequence of pseudochaotic coordination. At any rate, a combination of nonlinear biophysical and biochemical concepts provides an appropriate new paradigm for the interpretation of the pathogenesis of thrombotic events conventionally paraphrased as Virchow's triad.

Is Hypoperfusion an Important Cause of Strokes? If So, How?

“…Blood flow at arterial bifurcations is complex even in normal nonstenotic arteries. Eddies, turbulence, flow separation, and vortices are common and vary with location along the arteries [94,95,96]. As an artery narrows, blood flow velocity increases within the center of the artery and flow separation becomes more prominent.…”