The response of the vessel wall to thrombosis: the in vivo study of venous thrombolysis.

Abstract

The vessel wall is the site of synthesis and regulation of the fibrinolytic system, and this delicate process is overwhelmed by occlusive thrombosis in veins. The endothelium may or may not survive thrombus formation, but has strong powers of regeneration, and is subsequently vital to the process of recanalizing the vessel. The endogenous fibrinolytic response to venous thrombosis is not well delineated but appears to involve both the newly formed endothelium within and beneath the organizing thrombus, together with an increase in tissue plasminogen activator synthesis or storage in distant uninvolved veins. The further use of thrombus models in which the endothelium is not definitely damaged should enable greater understanding of its role. Immunocytochemistry and in situ hybridization may be helpful in defining some of the unanswered questions.