Thrombosis: Conditions, Types, Travel Pathways, and Integrated Chinese-Western Treatment
Thrombosis refers to the process in which, within the heart or blood vessels of a living body, the blood coagulates or certain components of the blood aggregate to form a solid mass. The solid mass that forms is called a thrombus. A thrombus may travel with the bloodstream and occlude a vessel lumen, causing embolism and infarction. Infarction refers to hypoxic necrosis of local tissue or an organ due to vascular obstruction.
Thrombosis can occur anywhere in the body where there are blood vessels. The conditions for thrombosis include the following: (1) injury to the endothelial cells of the heart and blood vessels; (2) changes in blood flow, such as slowing of blood flow or formation of vortices; (3) increased blood coagulability.
A thrombus is the main component of emboli in the human body, accounting for about 99% of all emboli. The pathway of a traveling thrombus generally follows the direction of blood flow, eventually lodging in a vessel of comparable caliber and blocking blood flow.
The travel pathways of thrombi from different sources are as follows: (1) Thrombi from the aortic system and left heart travel with the arterial blood flow and lodge in the small arteries of various organs, commonly in the brain, spleen, kidney, and extremities; (2) thrombi from the systemic venous system and right heart enter the main pulmonary artery and its branches with the blood flow, causing pulmonary embolism; (3) portal venous system thrombi can cause embolism of intrahepatic portal vein branches; (4) thrombi in the right heart or vena cava system can pass through a defect into the left heart, causing embolism of the systemic arterial system; (5) when pressure in the thoracic or abdominal cavity suddenly rises, a thrombus in the inferior vena cava may transiently reverse-flow into branches of the femoral, hepatic, or renal veins and cause embolism.
Usually, thrombosis does not occur in isolation but coincides with acute and chronic diseases such as fracture, inflammation, tumor, diabetes, hyperlipidemia, hypertension, and atherosclerosis. Therefore, treating thrombosis requires not only targeted anticoagulation and thrombolysis but also treatment of the patient's underlying diseases.
Thrombolytic treatment generally uses blood-activating and stasis-resolving (huoxue huayu) drugs, such as aspirin among Western drugs, and Danshen (Salviae Miltiorrhizae Radix et Rhizoma), Chishao (Paeoniae Rubra Radix), Chuanxiong (Chuanxiong Rhizoma), Sanleng (Sparganii Rhizoma), Ezhu (Curcumae Rhizoma), Ruxiang (Olibanum), Moyao (Myrrha), and Danggui (Angelicae Sinensis Radix) among Chinese medicines. If the patient has other underlying diseases, other drugs must be used concurrently during thrombolytic treatment, such as anticancer drugs, anti-inflammatory and antibacterial drugs, or hypoglycemic drugs.