Hypercoagulable States

  • Guillermo A. Escobar
  • Peter K. Henke
  • Thomas W. Wakefield
Chapter

Abstract

Thrombophilia refers to the tendency toward thrombosis that may have an inherited component which predisposes toward thrombosis but requires interaction with other components before the onset of the clinical disorder. Thrombosis occurs when there is an imbalance between the two classic coagulation pathways that lead to stable fibrin cross-linking and the native anticoagulant and fibrinolytic systems that inhibit or degrade clot formation.

Many factors associated with arterial or venous thrombosis are increased with age and trauma and are preventable with appropriate prophylaxis with heparin, or compression devices in high-risk groups. May-Thurner and Paget-Schroetter syndromes are due to compression of the iliac or subclavian veins, respectively, that may lead to thrombosis. Several diseases associated with a hypercoagulable state include cancer, essential thrombocytosis, polycythemia vera, treated HIV infections and heparin-induced thrombocytopenia.

The management of thrombosis includes anticoagulants, vena cava filters, endovascular mechanical devices, and thrombolytics.

Keywords

Aspirin Heparin Thrombocytopenia Perforation Fibrinogen 

References

  1. 1.
    Mackman N, Tilley RE, Key NS. Role of the extrinsic pathway of blood coagulation in hemostasis and thrombosis. Arterioscler Thromb Vasc Biol. 2007;27:1687–93.PubMedCrossRefGoogle Scholar
  2. 2.
    McDonald AP, Meier TR, Hawley AE, et al. Aging is associated with impaired thrombus resolution in a mouse model of stasis induced thrombosis. Thromb Res. 2010;125:72–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Knipp BS, Ferguson E, Williams DM, et al. Factors associated with outcome after interventional treatment of symptomatic iliac vein compression syndrome. J Vasc Surg. 2007;46:743–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Rice L. Centers for Disease Control and Prevention ICD-9-CM Coordination and Maintenance Committee Meeting- Diagnosis Agenda. In: Prevention CfDCa, ed.; 2007.Google Scholar
  5. 5.
    Prechel M, Walenga JM. The laboratory diagnosis and clinical management of patients with heparin-induced thrombocytopenia: an update. Semin Thromb Hemost. 2008;34:86–96.PubMedCrossRefGoogle Scholar
  6. 6.
    Warkentin TE, Greinacher A, Koster A, Lincoff AM. Treatment and prevention of heparin-induced thrombocytopenia: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133:340S–80S.PubMedCrossRefGoogle Scholar
  7. 7.
    Gangat N, Wolanskyj AP, Schwager SM, Hanson CA, Tefferi A. Leukocytosis at diagnosis and the risk of subsequent thrombosis in patients with low-risk essential thrombocythemia and polycythemia vera. Cancer. 2009;115:5740–5.PubMedCrossRefGoogle Scholar
  8. 8.
    Dellinger RP, Levy MM, Carlet JM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med. 2008;36:296–327.PubMedCrossRefGoogle Scholar
  9. 9.
    Kearon C, Kahn SR, Agnelli G, Goldhaber S, Raskob GE, Comerota AJ. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133:454S–545S.PubMedCrossRefGoogle Scholar
  10. 10.
    Usoh F, Hingorani A, Ascher E, et al. Long-term follow-up for superior vena cava filter placement. Ann Vasc Surg. 2009;23:350–4.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Guillermo A. Escobar
    • 1
  • Peter K. Henke
    • 1
  • Thomas W. Wakefield
    • 2
  1. 1.Section of Vascular SurgeryUniversity of Michigan Health SystemAnn ArborUSA
  2. 2.Section of Vascular Surgery, 5463 Cardiovascular CenterUniversity of Michigan Health SystemAnn ArborUSA

Personalised recommendations