It is named after the renowned GermanphysicianRudolf Virchow (1821–1902). However, the elements comprising Virchow's triad were not proposed by Virchow. Neither did he ever suggest a triad to describe the pathogenesis of venous thrombosis. In fact, it was not until decades after Virchow's death that a consensus was reached proposing that thrombosis is the result of alterations in blood flow, vascular endothelial injury, or alterations in the constitution of the blood. Still, the modern understanding of the factors leading to embolism is similar to the description provided by Virchow. Virchow's triad remains a useful concept for clinicians and pathologists alike in understanding the contributors to thrombosis.[2]
The first category, alterations in normal blood flow, refers to several situations. These include venous stasis, long surgical operations, prolonged immobility (whilst on a long plane or car ride, bed bound during hospitalization), and varicose veins. The equivalence of Virchow's version and the modern version has been disputed.[5]
Phenomena associated with irritation of the vessel and its vicinity
The last category, alterations in the constitution of blood,[6] has numerous possible risk factors such as hyperviscosity, coagulation factor V Leiden mutation, coagulation factor II G2021A mutation, deficiency of antithrombin III, protein C or S deficiency, nephrotic syndrome, changes after severe trauma or burn, cancer, late pregnancy and delivery, race, advanced age, cigarette smoking, hormonal contraceptives, and obesity. All of these risk factors can cause the situation called hypercoagulability (excessively easy clotting of blood).
Historyedit
The origin of the term "Virchow's Triad" is of historical interest, and has been subject to reinterpretation in recent years.[7] While both Virchow's and the modern triads describe thrombosis, the previous triad has been characterized as "the consequences of thrombosis", and the modern triad as "the causes of thrombosis".[8]
Rudolf Virchow elucidated the etiology of pulmonary embolism, whereby thrombi occurring within the veins, particularly those of the extremities, become dislodged and migrate to the pulmonary vasculature. He published his description in 1856.[9] In detailing the pathophysiology surrounding pulmonary embolism, he alluded to many of the factors known to contribute to venous thrombosis. While these factors had already been previously established in the medical literature by others,[10][11] for unclear reasons they ultimately became known as Virchow's triad. This eponym did not emerge in the literature until long after Virchow's death. One estimate of the first use of the phrase dates it to the early 1950s.[3]
Although the concept of the triad is usually attributed to Virchow, he did not include endothelial injury in his description.[12] This has been attributed to a dispute Virchow had with Jean Cruveilhier, who considered local trauma of primary importance in the development of pulmonary artery thrombosis.[13][14]
Referencesedit
^April Wang Armstrong; David E. Golan; Armen H. Tashjian; Ehrin Armstrong (2008). Principles of pharmacology: the pathophysiologic basis of drug therapy. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 396. ISBN978-0-7817-8355-2.
^Bagot CN, Arya R (October 2008). "Virchow and his triad: a question of attribution". Br. J. Haematol. 143 (2): 180–190. doi:10.1111/j.1365-2141.2008.07323.x. PMID 18783400.
^ abMalone, P. Colm, Agutter, Paul S. (2008). The Aetiology of Deep Venous Thrombosis: A Critical, Historical and Epistemological Survey. Paris: Springer. p. 84. ISBN978-1-4020-6649-8. from the original on 2022-10-15. Retrieved 2021-12-06.{{cite book}}: CS1 maint: multiple names: authors list (link)
^Dickson, B.C. (2004). (PDF). University of Toronto Medical Journal. 81: 166–171. Archived from the original (PDF) on 2016-03-05. Retrieved 2012-05-09.
^. Archived from the original on 2016-03-03. Retrieved 2009-02-10 – via Free Online Library.
^Virchow, R. (1856). "Thrombose und Embolie. Gefässentzündung und septische Infektion". Gesammelte Abhandlungen zur wissenschaftlichen Medicin (in German). Frankfurt am Main: Von Meidinger & Sohn. pp. 219–226.Matzdorff AC, Bell WR (1998). Thrombosis and embolie (1846–1856). Canton, Massachusetts: Science History Publications. ISBN0-88135-113-X.
^. Archived from the original on 2016-03-04. Retrieved 2009-02-10 – via Free Online Library.
^Wiseman R. Several Chirurgical Treatises. (2nd ed.) London, Norton and Macock, 1686, pp. 64–66.
^. Archived from the original on 2016-03-03. Retrieved 2009-02-10 – via Free Online Library.
^Aschoff L. Thrombosis, in Lectures on Pathology. New York, Paul B. Hoeber, Inc., 1924, pp 253–278.
April 08, 2024
virchow, triad, triad, virchow, ɪər, describes, three, broad, categories, factors, that, thought, contribute, thrombosis, hypercoagulability, hemodynamic, changes, stasis, turbulence, endothelial, injury, dysfunctiondifferential, diagnosisthrombosis, named, af. Virchow s triad or the triad of Virchow ˈ f ɪer k oʊ describes the three broad categories of factors that are thought to contribute to thrombosis 1 Hypercoagulability Hemodynamic changes stasis turbulence Endothelial injury dysfunctionVirchow s triadVirchow s triadDifferential diagnosisthrombosis It is named after the renowned German physician Rudolf Virchow 1821 1902 However the elements comprising Virchow s triad were not proposed by Virchow Neither did he ever suggest a triad to describe the pathogenesis of venous thrombosis In fact it was not until decades after Virchow s death that a consensus was reached proposing that thrombosis is the result of alterations in blood flow vascular endothelial injury or alterations in the constitution of the blood Still the modern understanding of the factors leading to embolism is similar to the description provided by Virchow Virchow s triad remains a useful concept for clinicians and pathologists alike in understanding the contributors to thrombosis 2 Contents 1 The triad 2 History 3 ReferencesThe triad editThe triad consists of three components Virchow s 3 Modern NotesPhenomena of interrupted blood flow Stasis 4 The first category alterations in normal blood flow refers to several situations These include venous stasis long surgical operations prolonged immobility whilst on a long plane or car ride bed bound during hospitalization and varicose veins The equivalence of Virchow s version and the modern version has been disputed 5 Phenomena associated with irritation of the vessel and its vicinity Endothelial injury or vessel wall injury The second category injuries and or trauma to endothelium includes vessel piercings and damages arising from shear stress or hypertension This category is ruled by surface phenomena and contact with procoagulant surfaces such as bacteria shards of foreign materials biomaterials of implants or medical devices membranes of activated platelets and membranes of monocytes in chronic inflammation Phenomena of blood coagulation Hypercoagulability The last category alterations in the constitution of blood 6 has numerous possible risk factors such as hyperviscosity coagulation factor V Leiden mutation coagulation factor II G2021A mutation deficiency of antithrombin III protein C or S deficiency nephrotic syndrome changes after severe trauma or burn cancer late pregnancy and delivery race advanced age cigarette smoking hormonal contraceptives and obesity All of these risk factors can cause the situation called hypercoagulability excessively easy clotting of blood History editThe origin of the term Virchow s Triad is of historical interest and has been subject to reinterpretation in recent years 7 While both Virchow s and the modern triads describe thrombosis the previous triad has been characterized as the consequences of thrombosis and the modern triad as the causes of thrombosis 8 Rudolf Virchow elucidated the etiology of pulmonary embolism whereby thrombi occurring within the veins particularly those of the extremities become dislodged and migrate to the pulmonary vasculature He published his description in 1856 9 In detailing the pathophysiology surrounding pulmonary embolism he alluded to many of the factors known to contribute to venous thrombosis While these factors had already been previously established in the medical literature by others 10 11 for unclear reasons they ultimately became known as Virchow s triad This eponym did not emerge in the literature until long after Virchow s death One estimate of the first use of the phrase dates it to the early 1950s 3 Although the concept of the triad is usually attributed to Virchow he did not include endothelial injury in his description 12 This has been attributed to a dispute Virchow had with Jean Cruveilhier who considered local trauma of primary importance in the development of pulmonary artery thrombosis 13 14 References edit April Wang Armstrong David E Golan Armen H Tashjian Ehrin Armstrong 2008 Principles of pharmacology the pathophysiologic basis of drug therapy Philadelphia Wolters Kluwer Health Lippincott Williams amp Wilkins p 396 ISBN 978 0 7817 8355 2 Bagot CN Arya R October 2008 Virchow and his triad a question of attribution Br J Haematol 143 2 180 190 doi 10 1111 j 1365 2141 2008 07323 x PMID 18783400 a b Malone P Colm Agutter Paul S 2008 The Aetiology of Deep Venous Thrombosis A Critical Historical and Epistemological Survey Paris Springer p 84 ISBN 978 1 4020 6649 8 Archived from the original on 2022 10 15 Retrieved 2021 12 06 a href Template Cite book html title Template Cite book cite book a CS1 maint multiple names authors list link Lowe GD 2003 Virchow s triad revisited abnormal flow Pathophysiol Haemost Thromb 33 5 6 455 457 doi 10 1159 000083845 PMID 15692260 Further reflections on Virchow s triad Archived from the original on 2016 03 05 Retrieved 2009 02 10 via Free Online Library Chung I Lip GY 2003 Virchow s triad revisited blood constituents Pathophysiol Haemost Thromb 33 5 6 449 454 doi 10 1159 000083844 PMID 15692259 Dickson B C 2004 Venous thrombosis on the history of Virchow s triad PDF University of Toronto Medical Journal 81 166 171 Archived from the original PDF on 2016 03 05 Retrieved 2012 05 09 Response further reflections on Virchow s Triad Archived from the original on 2016 03 03 Retrieved 2009 02 10 via Free Online Library Virchow R 1856 Thrombose und Embolie Gefassentzundung und septische Infektion Gesammelte Abhandlungen zur wissenschaftlichen Medicin in German Frankfurt am Main Von Meidinger amp Sohn pp 219 226 Matzdorff AC Bell WR 1998 Thrombosis and embolie 1846 1856 Canton Massachusetts Science History Publications ISBN 0 88135 113 X Virchow s triad Archived from the original on 2016 03 04 Retrieved 2009 02 10 via Free Online Library Wiseman R Several Chirurgical Treatises 2nd ed London Norton and Macock 1686 pp 64 66 synd 1223 at Who Named It Virchow s triad revisited Archived from the original on 2016 03 03 Retrieved 2009 02 10 via Free Online Library Aschoff L Thrombosis in Lectures on Pathology New York Paul B Hoeber Inc 1924 pp 253 278 Retrieved from https en wikipedia org w index php title Virchow 27s triad amp oldid 1190890746, wikipedia, wiki, book, books, library,
