Czaplicki Christopher, Albadawi Hassan, Partovi Sasan, Gandhi Ripal T, Quencer Keith, Deipolyi Amy R, Oklu Rahmi
Division of Vascular & Interventional Radiology, Mayo Clinic, Phoenix, AZ, USA.
University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Cardiovasc Diagn Ther. 2017 Dec;7(Suppl 3):S186-S196. doi: 10.21037/cdt.2017.11.05.
Venous thrombosis (VT) is a common yet complex clinical condition that has shown minimal alteration in clinical management for decades. It is well known that thrombus evolves structurally over time, with complex changes resulting from the interplay between coagulation factors, cytokines, leukocytes and a myriad of other factors. Our current treatment options are most effective in the acute thrombus, which is composed predominantly of a loose mesh of fibrin and red blood cells (RBCs), making current anticoagulation therapies and thrombolytics quite effective in treatment. Later stages of thrombus are more cellular containing leukocytes, and develop a fibrotic collagenous framework that is more resistant to our current treatments. Understanding the biology of an evolving thrombus will allow us to tailor our treatment and optimize outcomes, as well as focus on novel therapies for the treatment of chronic thrombus. Given the morbidity and mortality of both post thrombotic syndrome (PTS) in patients with deep VT, as well as chronic thromboembolic pulmonary hypertension (CTEPH) in patients with pulmonary embolism (PE), new and innovative therapies must continue to be explored to help prevent these potentially devastating conditions.
静脉血栓形成（VT）是一种常见但复杂的临床病症，几十年来其临床管理几乎没有变化。众所周知，血栓会随着时间推移在结构上发生演变，凝血因子、细胞因子、白细胞和众多其他因素之间的相互作用会导致复杂的变化。我们目前的治疗选择在急性血栓中最为有效，急性血栓主要由松散的纤维蛋白网和红细胞（RBC）组成，这使得目前的抗凝治疗和溶栓治疗在治疗中相当有效。血栓后期含有更多白细胞，且会形成对我们目前治疗更具抗性的纤维化胶原框架。了解不断演变的血栓生物学特性将使我们能够调整治疗方案并优化治疗效果，同时专注于治疗慢性血栓的新疗法。鉴于深静脉血栓形成患者的血栓后综合征（PTS）以及肺栓塞（PE）患者的慢性血栓栓塞性肺动脉高压（CTEPH）的发病率和死亡率，必须继续探索新的创新疗法以帮助预防这些潜在的毁灭性病症。
