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Postsurgical inflammation as a causative mechanism of venous thromboembolism

Postsurgical inflammation as a causative mechanism of venous thromboembolism
Postsurgical inflammation as a causative mechanism of venous thromboembolism
Surgery is associated with an increased risk of venous thromboembolic events (VTE) including deep vein thrombosis and pulmonary embolism. Although the current treatment regiments such as mechanical manipulation and administration of pharmacological prophylaxis significantly reduced the incidence of postsurgical VTE, they remain a major cause of postoperative morbidity and mortality worldwide. The pathophysiology of venous thrombosis traditionally emphasizes the series of factors that constitute Virchow triad of factors. However, inflammation can also be a part of this by giving rise to a hypercoagulable state and endothelial damage. The inflammatory response after surgery, which is initiated by a cytokine "storm" and occurs within hours of surgery, creates a prothrombotic environment that is further accentuated by several cellular processes including neutrophil extracellular traps formation, platelet activation, and the generation of tissue factor-bearing microparticles. Although such inflammatory markers are elevated in undergoing surgery, the precise mechanism by which they give rise to venous thrombosis is poorly understood. Here, we discuss the potential mechanisms linking inflammation to thrombosis, and highlight strategies that may minimize surgical inflammation and reduce the incidence of postoperative VTE.
0094-6176
615-620
Albayati, Mostafa A.
19b399e3-4132-4d1e-8478-fa489cfbce59
Grover, Steven P.
97917ca1-1247-472a-98d0-1949a35a04ae
Saha, Prakash
5e2ec0e9-1f2a-468e-a9ba-61317b0835ed
Lwaleed, Bashir A.
e7c59131-82ad-4a14-a227-7370e91e3f21
Modarai, Bijan
ac2cbae3-349c-4958-8bd2-ad85e640506f
Smith, Alberto
ee092ec8-aa94-4ec2-8d66-14d6e144e15f
Albayati, Mostafa A.
19b399e3-4132-4d1e-8478-fa489cfbce59
Grover, Steven P.
97917ca1-1247-472a-98d0-1949a35a04ae
Saha, Prakash
5e2ec0e9-1f2a-468e-a9ba-61317b0835ed
Lwaleed, Bashir A.
e7c59131-82ad-4a14-a227-7370e91e3f21
Modarai, Bijan
ac2cbae3-349c-4958-8bd2-ad85e640506f
Smith, Alberto
ee092ec8-aa94-4ec2-8d66-14d6e144e15f

Albayati, Mostafa A., Grover, Steven P., Saha, Prakash, Lwaleed, Bashir A., Modarai, Bijan and Smith, Alberto (2015) Postsurgical inflammation as a causative mechanism of venous thromboembolism. Seminars in Thrombosis and Hemostasis, 41 (6), 615-620. (PMID:26276933)

Record type: Article

Abstract

Surgery is associated with an increased risk of venous thromboembolic events (VTE) including deep vein thrombosis and pulmonary embolism. Although the current treatment regiments such as mechanical manipulation and administration of pharmacological prophylaxis significantly reduced the incidence of postsurgical VTE, they remain a major cause of postoperative morbidity and mortality worldwide. The pathophysiology of venous thrombosis traditionally emphasizes the series of factors that constitute Virchow triad of factors. However, inflammation can also be a part of this by giving rise to a hypercoagulable state and endothelial damage. The inflammatory response after surgery, which is initiated by a cytokine "storm" and occurs within hours of surgery, creates a prothrombotic environment that is further accentuated by several cellular processes including neutrophil extracellular traps formation, platelet activation, and the generation of tissue factor-bearing microparticles. Although such inflammatory markers are elevated in undergoing surgery, the precise mechanism by which they give rise to venous thrombosis is poorly understood. Here, we discuss the potential mechanisms linking inflammation to thrombosis, and highlight strategies that may minimize surgical inflammation and reduce the incidence of postoperative VTE.

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More information

e-pub ahead of print date: 15 August 2015
Published date: September 2015
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 393043
URI: https://eprints.soton.ac.uk/id/eprint/393043
ISSN: 0094-6176
PURE UUID: af8202da-0f5e-4af0-8375-6426ff79cc36

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Date deposited: 29 Jun 2016 15:17
Last modified: 04 Nov 2017 23:38

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