ABSTRACT
The development of a clot is a direct response to the injury of blood vessels or disruption of
normal vascular flow, and is dependent on a complex interaction between circulating blood platelets that help form a plug at the immediate site of injury1. Subsequently, through a complex series of protein, calcium, and phospholipid interactions, the coagulation cascade is activated, resulting in development of a fibrin clot. Rudolph Virchow described this triad of thromboembolic factors in the midnineteenth century. Thrombosis occurs in the context of endothelial injury, coagulable states and circulatory stasis. When thrombus occurs, a platelet-rich clot is frequently seen in areas of fast flow and has been described as a ‘white clot’, whereas the predominantly fibrinenriched clot (‘red’ clots) are seen in more sluggish swirling areas of vascular flow such as the venous system and the intracardiac chambers. However, mixed clots are not uncommon.
