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564 PART 7 ■ Principles and Disorders of Hemostasis and Thrombosis

thromb
Extern

c

T

Tunic

medi
Intern

Venous Tu

thrombus (endothelium)
(blood clot)

lve

Clumping of:
in

lood cells

blood vessel’s inner

lining

FIGURE 28.2 For ation o a venous thro bus. T e i ustration be ow shows the or ation o a venous thro bus.

Acquire con itions can a so contribute to a risk actor or recurrent, a i ia , or juveni e ee venous thro bosis or

thro bo hi ia (Box 28.2). occ usion in an unusua ocation such as a esenteric, bra-

chia , or cerebra vesse .

Primary States of Hypercoagulability

Secondary States of Hypercoagulability
Hy ercoagu ab e states inc u e various inherite an

acquire c inica isor ers characterize by an increase risk Secon ary hy ercoagu ation states ay be seen in a nu -

or thro boe bo is . ber o heterogeneous isor ers. In any o these con i-

Pri ary hy ercoagu ab e states ( ab e 28.11) inc u e re a- tions, en othe ia activation by cytokines ea s to the oss

tive y rare inherite con itions that ea to isor ere en o- o nor a vesse wa anticoagu ant sur ace unctions, with

the ia ce thro boregu ation. T ese con itions inc u e conversion to a roinf a atory thro bogenic henoty e.

ecrease thro bo o u in- e en ent activation o aPC, I ortant c inica syn ro es associate with substantia

i aire he arin bin ing o antithro bin (A ), or own- thro boe bo ic events inc u e the APS, he arin-in uce

regu ation o e brane-associate as in generation. thro bo athy, ye o ro i erative syn ro es, an cancer.

T e ajor inherite inhibitor isease states inc u e A Hy ercoagu abi ity can be associate with syste ic inf a -

e ciency, rotein C e ciency, an rotein S e ciency. ation ue ri ari y to an increase in rocoagu ant unctions,
T ese con itions shou be consi ere in atients who have an inhibition o brino ysis, an a own-regu ation o the