Antithrombotic physiology
Prevention of the coagulation cascade promoting a thrombus throughout the circulation resides with a number of physiological systems: (1)
- the fibrinolytic system
- the antithrombin system
- fibrin fragments, by-products of the fibrinolytic system, inhibit the formation of fibrin
- heparin from endogenous mast and endothelial cells
In practice, the systems interact in a dynamic manner towards a final common pathway of fibrin dissolution.
If required, non-physiological stimulation - with anticoagulants and thrombolytics - and inhibition - e.g. with tranexamic acid, aprotinin, desmopressin and ethmasylate - can modulate the system.
Reference
- Mackman N, Tilley RE, Key NS. Role of the extrinsic pathway of blood coagulation in hemostasis and thrombosis. Arterioscler Thromb Vasc Biol. 2007 Aug;27(8):1687-93.
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