Organization of thrombi

Stirling, G. A.; Tsapogas, Makis J.; Girolami, P.L.

doi:10.1002/bjs.1800530318

Cited by 17 publications

(7 citation statements)

References 9 publications

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“…Our observations of organization phenomena of in-vivo-formed thrombi partially agree with the observations of other authors (6,18,28) whereas other investigators observed a much earlier onset of organization (7,17,33,35,36).…”

Section: Organizationsupporting

confidence: 93%

Studies on Thrombolysis with Streptokinase

Gottlob¹,

Stockinger²,

Pötting³

et al. 1971

Thromb Haemost

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SummaryIn vitro whole blood clots of various ages, experimental thrombi produced in the jugular vein of rabbits and human thrombi from arteries and veins were examined in semi-thin sections and by means of electron microscopy.In all types of clots examined a typical course of retraction was found. Retraction starts with a dense excentrical focus which grows into a densification ring. After 24 hours the entire clot becomes almost homogeneously dense; later a secondary swelling sets in.Shortly after coagulation the erythrocytes on the rim of the clot are bi-concave discs. They then assume the shape of crenate spheres, turn into smooth spheres and finally become indented ghosts which have lost the largest part of their contents. In the inner zone, which makes up the bulk of the clot, we observed bi-concave discs prior to retraction. After retraction we see no crenations but irregularly shaped erythrocytes. Once the secondary swelling sets in, the cross-section becomes polygonal and later spherical. After extensive hemolysis we observe the “retiform thrombus” made up of ghosts.Experimental and clinical thrombi present the same morphology but are differentiated from in vitro clots by: earlier hemolysis, immigration of leukocytes, formation of a rim layer consisting of fibrin and thrombocytes, and the symptoms of organization. Such symptoms of organization which definitely will prevent lysis with streptokinase were found relatively late in experimental and clinical thrombi. Capillary buds and capillary loops were never found in clinical thrombi prior to the third month.The morphological findings agree with earlier physical and enzymatic investigations. The observation that phenomena of reorganization occur relatively late and frequently only in the rim areas of large thrombi explains why lytic therapy is possible in some of the chronic obliterations.

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Section: Organizationsupporting

confidence: 93%

Studies on Thrombolysis with Streptokinase

Gottlob¹,

Stockinger²,

Pötting³

et al. 1971

Thromb Haemost

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“…Neovascular channels appear around the thrombus wall junction and within the thrombus as resolution proceeds3, 10, 11. Histological studies in rodent models suggest that these channels are derived from the vein wall3, and they may also be derived from cells residing in the thrombus63. We have found that enhancing the levels of either VEGF alone, or simultaneously with a number of other angiogenic factors through upregulation of HIF1a within the thrombus, enhances its resolution64-67.…”

Section: Venous Thrombus Resolutionmentioning

confidence: 67%

Leukocytes and the Natural History of Deep Vein Thrombosis

Saha

Humphries

Modarai

et al. 2011

ATVB

162

139

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“…Avenous thrombus isalaminarstructureconsisting of layers of platelets,leukocytesand fibrin (linesof Zahn),whiche ncompass the main redcellmass.Avariety of animalmodelsof thrombosishavebeen developed tostudyvenous thrombus resolution,b ut most studieshaveusedrodentmodels (28)(29)(30)(31)(32)(33). A primatemodel of thrombosis(34) isclosertohumansin its naturalh istory,b ut iss eldome mployed,a sprimatesaree xpensive and thereisaperceived publicdisquietwiththeiruse.…”

Section: Thrombosismodelsmentioning

confidence: 99%

“…The sourceofthe "endothelial-like" cellsthatarerecruited intoorganising thrombus,isnotknown. Itisu nlikelyt hatt he vascularchannelsare onlyderived fromthe venavenorain the veinwall,asclefts lined bythe "endothelial-like" cellsappearandorganisation still takes place(albeittoalesserdegree) when experimentalthrombiare isolated fromthe wall byanimpervious membrane (29). Recanalisation and endothelialisation occurs in athrombus exposed toflowingblood thatisplaced in apermeable membrane which prevents contactw iththe vessel wall (66).…”

Section: The Endothelialcomponentmentioning

confidence: 99%

The role of neovascularisation in the resolution of venous thrombus

Modarai

Burnand²,

Humphries³

et al. 2005

Thromb Haemost

108

128

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Deep vein thrombosis (DVT) can give rise to chronic debilitating complications, which are expensive to treat. Anticoagulation, the standard therapy for DVT, prevents propagation, but does not remove the existing thrombus, which undergoes slow natural resolution. Alternative forms of treatment that accelerate resolution may arise from a better understanding of the cellular and molecular pathways that regulate the natural resolution of thrombi. This review will outline our current understanding of the mechanisms of thrombus resolution and the role of neovascularisation in this process. Novel experimental treatments that may one day find clinical use are also discussed. The process of thrombus resolution resembles wound healing. The mainly monocytic inflammatory infiltrate, which develops, is associated with the appearance of vascular channels. These cells may drive resolution by encouraging angiogenesis, which contributes to restoration of the vein lumen. Significant numbers of bone marrow-derived progenitor cells have also been found in naturally resolving thrombi, but their precise phenotype and their role in thrombus recanalisation is unclear. Enhanced thrombus neovascularisation and rapid vein recanalisation have been achieved in experimental models with proangiogenic agents. Recent reports of the role of bone marrow-derived progenitor cells in the revascularisation of ischaemic tissues suggest that it may be possible to obtain the same effect by delivering pluripotent or lineage specific stem cells into thrombus. These cells could contribute to thrombus recanalisation by expressing a variety of proangiogenic cytokines or by lining the new vessels that appear within the thrombus.

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Organization of thrombi

Cited by 17 publications

References 9 publications

Studies on Thrombolysis with Streptokinase

Studies on Thrombolysis with Streptokinase

Leukocytes and the Natural History of Deep Vein Thrombosis

The role of neovascularisation in the resolution of venous thrombus

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