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Peripheral Artery Disease: causes and consequences

Coronary Artery Disease: causes and consequences

Haemostasis

This section describes the role of haemostasis and the importance of balancing its constituent processes in healthy vascular function
 

  • Haemostasis is the normal physiological response that prevents significant blood loss after vascular injury1
  • Haemostasis depends on an intricate series of events involving platelets, other blood cells, such as TF-bearing cells, and the activation of specific blood proteins, known as coagulation factors1
    • Knowledge of haemostasis is important in understanding major disease states associated with thrombosis, such as:
      • VTE
      • Atherothrombosis (thrombosis triggered by plaque rupture)
      • Cardioembolic stroke

 

Initiation of haemostasis

  • When blood vessel injury occurs, physiological haemostasis is triggered and the sequence of events listed below takes place:
    • The vessel constricts to reduce blood flow
    • Circulating platelets adhere to the vessel wall at the site of trauma
    • Platelets are activated and aggregate
    • An intricate series of enzymatic reactions occur involving coagulation proteins
    • Fibrin is produced to form a stable haemostatic plug

 

Balancing haemostasis

  • Haemostasis is a finely tuned process involving the dual pathways of platelet activation and coagulation cascade initiation
  • It serves to maintain the integrity of the circulatory system2
  • However, the process can become imbalanced, leading to significant morbidity and mortality3
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The process of coagulation depends on a complex interplay of enzymatic and cellular activity, culminating in the formation of a stable vascular ‘plug’. The subsequent process of clot dissolution that occurs during the healing phase is known as fibrinolysis

References
  • Colman RW, Clowes AW, George JN et al. Overview of hemostasis. In Hemostasis and Thrombosis: Basic Principles and Clinical Practice. 5th edn. Colman RW, Clowes AW, George JN et al. (editors). Philadelphia: Lippincott, Williams & Wilkins; 2006. p. 1–16. Return to content
  • Adams GL, Manson RJ, Turner I et al. The balance of thrombosis and hemorrhage in surgery. Hematol Oncol Clin North Am 2007;21:13–24. Return to content
  • Heit JA. Venous thromboembolism: disease burden, outcomes and risk factors. J Thromb Haemost 2005;3:1611–1617. Return to content

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