ABSTRACT
Obstruction of arteries or veins by thrombus develops secondary to a wide variety of pathological disorders. Predisposing factors include primary arterial pathology as in obstructive atherosclerosis and altered haemodynamics, as in deep venous thrombosis and hypercoagulable conditions. Other clinical presentations involve the distal manifestation of thrombi, remote to their site of origin, as in embolic occlusion of arterial beds from cardiac mural thrombi. The management of arterial thrombi hinges on the rapid restoration of blood flow in the obstructed vessel and thereby in the prevention of further ischaemia in the distal bed. On the venous side, the goal is to prevent distal embolism and chronic damage to the occluded veins. In both situations, local thrombolytic therapy is currently frequently used for treatment.
