Definition and Overview

Arterial thrombosis refers to the formation of blood clots in arteries or blood vessels that carry blood from the heart to the rest of the body. Although the condition does not always produce symptoms, it can be a cause for concern because a blood clot has the potential to partially or completely block an artery and prevent the blood from flowing to vital organs.

Thrombosis is a medical term that refers to the body’s process of blood clotting in which platelets and proteins in the plasma work together to prevent excessive bleeding when a blood vessel is injured. In normal circumstances, the body dissolves the blood clot right after the injury has healed. However, in some cases, blood clots fail to dissolve and obstruct an artery. They can also be dislodged, travel to the bloodstream, and end up in arteries that supply blood to the brain, heart, or lungs. This increases the risk of life-threatening medical conditions, including a heart attack, stroke or mini stroke, and pulmonary embolism.

Causes of Condition

In the majority of cases, atrial thrombosis is caused by atherosclerosis, a condition in which plaque builds up around the artery wall and causes the arteries to narrow or harden.

The arteries are lined by endothelium, which allows the blood to flow smoothly. When the endothelium is damaged, a plaque that is mostly made up of cholesterol, calcium, and other substances from the blood begins to accumulate in the artery wall. The condition increases the risk of blood clot formation. In some cases, the plaque eventually breaks open and causes blood cell fragments to accumulate in the affected area. These fragments may stick together and also form blood clots.

The risk of developing atherosclerosis can be increased by an unhealthy and sedentary lifestyle, being overweight or obese, diabetes, a family history of the condition, and high blood and cholesterol levels.

Key Symptoms

Arterial thrombosis does not cause any noticeable symptoms until an artery is blocked and the flow of blood to some parts of the body is interrupted. Depending on the location of the blockage, a patient may suffer from:

  • Heart attack, which symptoms include chest pain or discomfort that radiates to other areas of the upper body, shortness of breath, nausea, and lightheadedness.

  • Stroke, which symptoms include sudden confusion, numbness or weakness of one side of the body, vision problems, and loss of balance, among others.

  • Pulmonary embolism, which symptoms include chest pain, coughing up blood, an unexplained sudden onset of shortness of breath, and rapid pulse.

Who to See and Types of Treatments Available

Since arterial thrombosis does not cause symptoms, it is often diagnosed when the patient has already suffered a stroke or heart attack. As a preventive measure, people who are considered high risk, or those who have risk factors mentioned above, are given medications to prevent blood clots from forming. These medications include:

  • Statins - Statins are a class of medicines that block the action of an enzyme in the liver that the body uses in making cholesterol to lower the patient’s blood cholesterol levels.

  • Anticoagulants - Anticoagulants, such as warfarin, are also commonly called blood thinners. They work by delaying the clotting of blood.

  • Antiplatelets - Antiplatelets, such as low-dose aspirin, are commonly used to reduce the risk of a heart attack.

  • Thrombolytics - Thrombolytics work by dissolving dangerous clots in blood vessels to restore normal blood flow and prevent irreversible damage to tissues and organs.

If nonsurgical therapies fail to dissolve the blood clot, a surgical procedure called thrombectomy or embolectomy can be recommended. It can be performed using a catheter (minimally invasive method) with a balloon at its tip. For the procedure, the catheter is inserted into a small cut in the body and threaded to the site of the blockage. The small balloon is then inflated and deflated to remove the clot. In some cases, open surgery is necessary and is often preferred in emergency situations. It involves making a large incision to open up the artery so the blood clot can be removed. Although both procedures are highly effective in treating atrial thrombosis, the minimally invasive method is generally preferred because it minimises the common risks of surgery including infection, bleeding, and scarring. It also minimises recovery time, allowing patients to go back to their daily routine in just a matter of days.

In cases where the artery is damaged beyond repair, surgeons recommend coronary artery bypass graft surgery in which a blood vessel taken from another part of the patient’s body is used to go around the blockage so normal blood flow to the heart can be restored.

References:

  • Alonso-Coello P, Bellmunt S, McGorrian C, et al. Antithrombotic therapy in peripheral arterial disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e669S-e690S. PMID: 22315275 www.ncbi.nlm.nih.gov/pubmed/22315275.

  • Rooke TW, Hirsch AT, Misra S, et al. 2011 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Peripheral Artery Disease (Updating the 2005 Guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2011;58:2020-2045. PMID: 21963765

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