Interplay among abnormalities in blood components, the vasculature, and blood flow contribute to the development of venous thrombosis. Venous thrombosis involves the formation of fibrin-rich “red clots” that result from exposure of procoagulant activity on intact endothelium plus plasma hypercoagulability, in reduced or static blood flow. Venous thrombi are thought to initiate behind valve pockets, in which reduced or static flow decreases wall shear stress that normally regulates endothelial cell phenotype. TM = thrombomodulin; EPCR = endothelial protein C receptor; II = prothrombin; IIa = thrombin; TF = tissue factor; Fgn = fibrinogen; RBC = red blood cells.
Wolberg AS, Aleman MM, Thrombosis Research 2010 Apr;125 Suppl 1:S35-7