Trombóny

Trombóny (thrombi) are solid masses formed within blood vessels when components of blood, particularly platelets and fibrin, accumulate and occlude flow. They can develop in arteries or veins. Arterial trombi often form at sites of atherosclerotic plaque and can cause myocardial infarction or ischemic stroke, while venous trombi typically develop in deep veins of the legs and may lead to deep vein thrombosis; fragments can migrate to the lungs, causing a pulmonary embolism.

Pathophysiology: Thrombus formation is explained by Virchow's triad—stasis, endothelial injury, and hypercoagulability. Risk factors include prolonged immobility, recent surgery, cancer, pregnancy, hormonal therapy, obesity, smoking, and inherited clotting disorders.

Diagnosis: D-dimer testing is sensitive but nonspecific. Imaging is used to confirm suspected trombóny: compression ultrasonography for deep vein thrombosis; CT pulmonary angiography or ventilation–perfusion scanning for pulmonary embolism.

Treatment and prevention: Anticoagulation with heparin, vitamin K antagonists, or direct oral anticoagulants is the mainstay. In extensive or life-threatening cases, thrombolysis or mechanical thrombectomy may be considered. Preventive measures include mobilization, compression stockings, and pharmacologic prophylaxis in high-risk situations.

Prognosis: With treatment, many tromóny resolve, but complications such as post-thrombotic syndrome, chronic thromboembolic pulmonary hypertension, and recurrent events can occur.