The George E. Brown Memorial Lecture

Abstract

The pathogenesis of intravascular thrombosis involves 1 or a combination of 3 factors: an endothelial lesion, a disturbance of blood flow, and hypercoagulability of the blood. The fate of fresh thrombi is probably dependent on the fibrinolytic activity of the plasma. While some tests for coagulation factors have given some positive results among patients with various types of thrombosis, no test has consistently demonstrated its value in predicting a thrombosing tendency. Carefully administered anticoagulant therapy has been effective in the prevention of thrombosis in many patients. Such therapy requires individualization on the basis of frequent laboratory tests and is usually justified only after the patient has suffered one or more episodes of clinical thrombosis. Treatment of acute thrombosis by intravascular injections of fibrinolysins is still in the experimental stage. Recent advances in surgical technic have led to successful restoration of continuity of some of the large arteries previously occluded by thrombosis.