What is Thromboembolism?

Thromboembolism
Thromboembolism. Histopathology of the kidney (A), showing a focal area of cortical ischemic tissue extending into the medulla (I) caused by complete obliteration of an interlobar artery (asterisk) by a thromboembolus. The arrows indicate the hemorrhagic borders of the infarction (H&E, 200×). Histopathology of the heart (B), showing the area of ischemic necrosis in the subepicardial myocardium (arrow) secondary to complete obliteration of the coronary artery lumen by a thromboembolus (asterisk) (H&E, 40×). Higher magnification (C) shows the necrotic myocardiocytes (N), characterized by hypereosinophilia, loss of cytoplasmic details, and contraction bands (arrow), and the interstitium expanded by edema and infiltrating leukocytes (dashed arrow) (H&E, 400×). Histopathology of the liver (D), showing wall of the centrolobular vein infiltrated by few lymphocytes and macrophages. The lumen of the vessel is severely narrowed by an accumulation of round to oval eosinophilic cells (arrow), resembling dendritic cells (H&E, 400×). Multifocal ischemic brain infarctions secondary to spontaneous basilar artery occlusion in a dog with systemic thromboembolic disease. Salger F, Stahl C, Vandevelde M, Piersigilli A, Henke D - Journal of veterinary internal medicine / American College of Veterinary Internal Medicine (2014). Not Altered. CC.

Thromboembolism is the obstruction of a blood vessel by a blood clot. It is responsible for approximately 95% of embolisms.

What is the Pathology of Thromboembolism?

The pathology of thromboembolism is:

-Etiology: The cause of thromboembolism is family history, sedentary lifestyle, older age, obesity, smoking, high blood pressure, high cholesterol, and diabetes.

-Genes involved: Certain clotting factor abnormalites may be implicated.

-Pathogenesis: The sequence of events that lead to thromboembolism depends upon Virchow’s triad, i.e, presence of abnormalities of blood flow, blood vessel wall, and blood clotting components.

-Morphology: The morphology associated with thromboembolism shows large embolus may embed in major branches or lodge astride the bifurcation as a saddle embolus.

-Histology: The histology associated with thromboembolism shows necrosis, recanaliztion,  irregular, nonlaminar, often obliterative, intimai fibrosis.

How does Thromboembolism Present?

Patients with thromboembolism are typically males as compared to females present at the age range of over 60. The symptoms, features, and clinical findings associated with thromboembolism include heart attack, limb infarction, or even pneumonia, leg pain and tenderness, edema, sense of impending doom, anxiety, red and hot skin, and dilated veins.

How is Thromboembolism Diagnosed?

Thromboembolism is diagnosed using D-dimer blood test,  factor VIII blood test, platelet aggregation test, MRI, duplex ultrasound.

How is Thromboembolism Treated?

Thromboembolism is treated with anticoagulants, antiplatelets, and thrombolytics initially, if progressed then surgery is an option.

What is the Prognosis of Thromboembolism?

The prognosis of thromboembolism is fair, with short-term survival ranging from 95% to 97% for deep vein thrombosis, while long-term survival ranges from 61% to 75% for deep vein thrombosis.

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Last updated on May 19, 2022