Canterbury DHB
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The clotting process involves activation and consumption of coagulation factors and platelets, with the production of a fibrin-platelet thrombus. Normally, this is at the site of vessel injury. This clotting process is balanced by natural anti-coagulant factors (e.g. AT111 and protein C). The clot is lysed by the fibrinolytic system (alteplase, plasmin(ogen)).
In pathological states, macroscopic clots may form in the vascular lumen - arterial or venous. In other pathological states, microscopic clots occur in small blood vessels. These are usually quickly lysed by plasmin. As a result, thrombotic features may be not very apparent but there can be major changes in the clotting factors due to consumption. Microthrombi may present as poor tissue perfusion/function, commonly renal.
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Topic Code: 5216
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