Possible Complications

Possible Complications

The complications associated with thrombus formation depend greatly on its location and the effects of occlusion of the associated blood vessel(s).

Venous

• deep vein thrombosis (DVT)¹
  • formation of a thrombus within a deep vein
  • often causes pain, swelling and erythema
     
• portal vein thrombosis²
  • formation of a thrombus within the hepatic portal vein, obstructing blood flow to the liver
  • can cause portal hypertension and reduced liver function
     
• renal vein thrombosis³
  • formation of a thrombus within the renal vein
  • can cause kidney damage and kidney failure
     
• cerebral venous sinus thrombosis⁴
  • a rare condition which results from the obstruction of the dural venous sinuses by a thrombus
     

Arterial

• pulmonary embolism⁵
  • blockage of the pulmonary artery, often by a thrombus, causing obstruction of blood flow to the lungs
  • can cause difficulty breathing, chest pain and death
     
• stroke⁶
  • caused by a disturbance in blood supply to the brain
  • causes a rapid decline in brain function and subsequent tissue infarction
    • HIV/AIDS appears to increase the risk of both ischemic and hemorrhagic stroke, particularly in young patients who have few other risk factors for stroke. The mechanisms underlying increased stroke risk are not always understood, but may include alcohol, short duration of HAART, opportunistic infectious meningitides and vasculitides, liver/renal disease, primary HIV vasculopathy, altered coagulation and cardioembolic events^7-9 
       
• myocardial infarction¹⁰
  • caused by obstruction of a coronary artery
  • results in death (by ischemia) of cardiac tissue
     

Pharmaceutical

Patients treated for a thromboembolic disease, either prophylactically or therapeutically, may be receiving anticoagulant therapy. Such drugs can lead to:¹¹

• increased bleeding
• increased risk from hemorrhage
   

References

1. Turpie AGG. ABC of antithrombotic therapy. Venous thromboembolism: pathophysiology, clinical features, and prevention. BMJ. 2002;325:887–890
2. Shaffer EA. Portal Vein Disorders. Merck Manual. 2007.
3. Sadjad S. Renal Vein Thrombosis. Merck Manual. 2008.
4. Allroggen H, Abbott RJ. Cerebral venous sinus thrombosis. Postgrad Med J. 2000;76(891): 12–15.
5. Newman JH. Pulmonary Embolism. Merck Manual. 2010.
6. Giraldo EA. Overview of Stroke (Cerebrovascular Accident). Merck Manual. 2007.
7. Ovbiagele B, Nath A. Increasing incidence of ischemic stroke in patients with HIV infection. Neurology. 2011;76(5):444–450.
8. Dobbs MR, Berger JR. Stroke in HIV infection and AIDS. Expert Rev Cardiovasc Ther. 2009;7(10):1263–1271.
9. Corral I, Quereda C, Moreno A, et al. Cerebrovascular ischemic events in HIV-1-infected patients receiving highly active antiretroviral therapy: incidence and risk factors. Cerebrovasc Dis. 2009;27(6):559–563.
10. Warnica JW. Acute Coronary Syndromes. Merck Manual. 2007.
11. van der Meer FJ, Rosendaal FR, Vandenbroucke JP, Briët E. Bleeding complications in oral anticoagulant therapy. An analysis of risk factors. Arch Intern Med. 1993;153(13):1557–1562.