124:(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.
32:
309:
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, for unclear reasons they ultimately became known as
Virchow's triad. This
726:
608:
502:
317:
Although the concept of the triad is usually attributed to
Virchow, he did not include endothelial injury in his description. This has been attributed to a dispute Virchow had with
286:
The origin of the term "Virchow's Triad" is of historical interest, and has been subject to reinterpretation in recent years. While both
Virchow's and the modern triads describe
781:
305:, particularly those of the extremities, become dislodged and migrate to the pulmonary vasculature. He published his description in 1856. In detailing the
612:
488:
730:
774:
671:
506:
314:
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.
290:, the previous triad has been characterized as "the consequences of thrombosis", and the modern triad as "the causes of thrombosis".
767:
898:
461:
346:
163:, long surgical operations, prolonged immobility (whilst on a long plane or car ride, bed bound during hospitalization), and
467:
1073:
1056:
655:
1135:
1087:
569:
854:
1141:
1127:
1115:
1078:
948:
1268:
844:
601:
247:
The last category, alterations in the constitution of blood, has numerous possible risk factors such as
1223:
1068:
321:, who considered local trauma of primary importance in the development of pulmonary artery thrombosis.
1339:
910:
891:
1309:
1052:
881:
267:, late pregnancy and delivery, race, advanced age, cigarette smoking, hormonal contraceptives, and
336:
159:
The first category, alterations in normal blood flow, refers to several situations. These include
1406:
1401:
1299:
1092:
675:
1213:
1188:
1146:
44:
495:
1208:
1198:
1016:
251:, coagulation factor V Leiden mutation, coagulation factor II G2021A mutation, deficiency of
964:
859:
849:
453:
The
Aetiology of Deep Venous Thrombosis: A Critical, Historical and Epistemological Survey
8:
1396:
1203:
1193:
989:
869:
1329:
1011:
969:
816:
633:
Virchow, R. (1856). "Thrombose und
Embolie. Gefässentzündung und septische Infektion".
482:
294:
272:
256:
241:
209:
96:
341:. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 396.
1218:
994:
903:
759:
651:
550:
457:
429:
424:
407:
388:
342:
88:) describes the three broad categories of factors that are thought to contribute to
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984:
979:
839:
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419:
378:
318:
65:
719:
1324:
1158:
999:
864:
640:
451:
337:
April Wang
Armstrong; David E. Golan; Armen H. Tashjian; Ehrin Armstrong (2008).
306:
260:
213:
197:
167:. The equivalence of Virchow's version and the modern version has been disputed.
1349:
1061:
1004:
886:
714:
709:
248:
164:
121:
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1359:
1181:
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928:
217:
160:
153:
1102:
1369:
811:
554:
433:
392:
252:
229:
205:
193:
189:
1166:
974:
806:
795:
185:
107:
101:
664:
634:
584:
1354:
1319:
1294:
938:
920:
287:
89:
545:
528:
383:
366:
339:
Principles of pharmacology: the pathophysiologic basis of drug therapy
1344:
1289:
876:
225:
221:
118:
172:
Phenomena associated with irritation of the vessel and its vicinity
31:
1258:
1253:
1243:
933:
791:
639:(in German). Frankfurt am Main: Von Meidinger & Sohn. pp.
201:
1304:
1263:
449:
298:
268:
115:
16:
Three factors thought to cause internal blood clots (thrombosis)
1248:
311:
264:
74:
302:
271:. All of these risk factors can cause the situation called
80:
699:. (2nd ed.) London, Norton and Macock, 1686, pp. 64–66.
650:. Canton, Massachusetts: Science History Publications.
789:
636:
570:"Venous thrombosis: on the history of Virchow's triad"
77:
71:
754:. New York, Paul B. Hoeber, Inc., 1924, pp 253–278.
445:
443:
188:includes vessel piercings and damages arising from
68:
609:"Response: further reflections on Virchow's Triad"
408:"Virchow and his triad: a question of attribution"
1388:
440:
200:and contact with procoagulant surfaces, such as
529:"Virchow's triad revisited: blood constituents"
184:The second category, injuries and/or trauma to
360:
358:
330:
775:
645:
567:
487:: CS1 maint: multiple names: authors list (
632:
520:
399:
355:
782:
768:
450:Malone, P. Colm, Agutter, Paul S. (2008).
367:"Virchow's triad revisited: abnormal flow"
293:Rudolf Virchow elucidated the etiology of
30:
544:
423:
405:
382:
526:
503:"Further reflections on Virchow's triad"
132:The triad consists of three components:
1036:
364:
1389:
275:(excessively easy clotting of blood).
763:
577:University of Toronto Medical Journal
752:Thrombosis, in Lectures on Pathology
149:Phenomena of interrupted blood-flow
13:
648:Thrombosis and embolie (1846–1856)
14:
1418:
406:Bagot CN, Arya R (October 2008).
255:III, protein C or S deficiency,
1136:platelet storage pool deficiency
1088:Heparin-induced thrombocytopenia
740:– via Free Online Library.
685:– via Free Online Library.
622:– via Free Online Library.
516:– via Free Online Library.
425:10.1111/j.1365-2141.2008.07323.x
64:
744:
702:
689:
470:from the original on 2022-10-15
456:. Paris: Springer. p. 84.
237:Phenomena of blood-coagulation
204:, shards of foreign materials,
114:It is named after the renowned
855:Activated protein C resistance
646:Matzdorff AC, Bell WR (1998).
626:
561:
1:
697:Several Chirurgical Treatises
533:Pathophysiol. Haemost. Thromb
371:Pathophysiol. Haemost. Thromb
324:
949:Trousseau sign of malignancy
196:. This category is ruled by
127:
104:changes (stasis, turbulence)
7:
1269:Nonthrombocytopenic purpura
845:Antithrombin III deficiency
727:"Virchow's triad revisited"
10:
1423:
1224:Congenital afibrinogenemia
1128:Glanzmann's thrombasthenia
281:
1340:Gastrointestinal bleeding
1279:
1236:
1157:
1142:Hermansky–Pudlak syndrome
1101:
1043:
1029:
957:
919:
911:Antiphospholipid syndrome
892:Essential thrombocythemia
832:
825:
802:
583:: 166–171. Archived from
43:
38:
29:
24:
1310:Subconjunctival bleeding
1116:Bernard–Soulier syndrome
1079:Upshaw–Schulman syndrome
1053:Thrombocytopenic purpura
882:Sticky platelet syndrome
527:Chung I, Lip GY (2003).
1300:Intracranial hemorrhage
259:, changes after severe
1214:Factor XIII deficiency
1194:Hypoprothrombinemia/II
1189:von Willebrand disease
1147:Gray platelet syndrome
568:Dickson, B.C. (2004).
45:Differential diagnosis
1209:Factor XII deficiency
1199:Factor VII deficiency
1017:Renal vein thrombosis
301:occurring within the
965:Deep vein thrombosis
860:Protein S deficiency
850:Protein C deficiency
230:chronic inflammation
1204:Factor X deficiency
1093:May–Hegglin anomaly
870:Prothrombin G20210A
224:, and membranes of
25:Virchow's triad
1330:Pulmonary hematoma
1237:Signs and symptoms
1012:Pulmonary embolism
817:Bleeding diathesis
672:"Virchow's triad?"
295:pulmonary embolism
273:hypercoagulability
257:nephrotic syndrome
242:Hypercoagulability
180:vessel wall injury
176:Endothelial injury
110:injury/dysfunction
97:Hypercoagulability
1384:
1383:
1380:
1379:
1232:
1231:
1219:Dysfibrinogenemia
1103:Platelet function
1025:
1024:
904:Purpura fulminans
546:10.1159/000083844
463:978-1-4020-6649-8
384:10.1159/000083845
348:978-0-7817-8355-2
279:
278:
198:surface phenomena
53:
52:
19:Medical condition
1414:
1045:Thrombocytopenia
1041:
1040:
1034:
1033:
990:Lowenberg's sign
840:Clotting factors
830:
829:
784:
777:
770:
761:
760:
755:
748:
742:
741:
739:
738:
729:. Archived from
723:
717:
706:
700:
693:
687:
686:
684:
683:
674:. Archived from
668:
662:
661:
644:
630:
624:
623:
621:
620:
611:. Archived from
605:
599:
598:
596:
595:
589:
574:
565:
559:
558:
548:
539:(5–6): 449–454.
524:
518:
517:
515:
514:
505:. Archived from
499:
493:
492:
486:
478:
476:
475:
447:
438:
437:
427:
403:
397:
396:
386:
377:(5–6): 455–457.
365:Lowe GD (2003).
362:
353:
352:
334:
319:Jean Cruveilhier
135:
134:
87:
86:
83:
82:
79:
76:
73:
70:
60:triad of Virchow
34:
22:
21:
1422:
1421:
1417:
1416:
1415:
1413:
1412:
1411:
1387:
1386:
1385:
1376:
1325:Hemopericardium
1275:
1228:
1159:Clotting factor
1153:
1097:
1021:
970:Bancroft's sign
953:
944:Virchow's triad
915:
865:Factor V Leiden
821:
798:
788:
758:
749:
745:
736:
734:
725:
724:
720:
707:
703:
694:
690:
681:
679:
670:
669:
665:
658:
631:
627:
618:
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606:
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593:
591:
587:
572:
566:
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525:
521:
512:
510:
501:
500:
496:
480:
479:
473:
471:
464:
448:
441:
412:Br. J. Haematol
404:
400:
363:
356:
349:
335:
331:
327:
307:pathophysiology
284:
214:medical devices
130:
67:
63:
56:Virchow's triad
39:Virchow's triad
20:
17:
12:
11:
5:
1420:
1410:
1409:
1407:Medical triads
1404:
1402:Rudolf Virchow
1399:
1382:
1381:
1378:
1377:
1375:
1374:
1373:
1372:
1364:
1363:
1362:
1357:
1352:
1350:Hemoperitoneum
1347:
1342:
1334:
1333:
1332:
1327:
1322:
1314:
1313:
1312:
1307:
1302:
1297:
1292:
1283:
1281:
1277:
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1274:
1273:
1272:
1271:
1261:
1256:
1251:
1246:
1240:
1238:
1234:
1233:
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1229:
1227:
1226:
1221:
1216:
1211:
1206:
1201:
1196:
1191:
1186:
1185:
1184:
1179:
1174:
1163:
1161:
1155:
1154:
1152:
1151:
1150:
1149:
1144:
1132:
1131:
1130:
1120:
1119:
1118:
1107:
1105:
1099:
1098:
1096:
1095:
1090:
1084:
1083:
1082:
1081:
1076:
1066:
1065:
1064:
1062:Evans syndrome
1049:
1047:
1038:
1031:
1027:
1026:
1023:
1022:
1020:
1019:
1014:
1009:
1008:
1007:
1002:
997:
995:Peabody's sign
992:
987:
982:
977:
972:
961:
959:
955:
954:
952:
951:
946:
941:
936:
931:
925:
923:
917:
916:
914:
913:
908:
907:
906:
896:
895:
894:
889:
887:Thrombocytosis
884:
874:
873:
872:
867:
862:
857:
852:
847:
836:
834:
827:
823:
822:
820:
819:
814:
809:
803:
800:
799:
787:
786:
779:
772:
764:
757:
756:
743:
718:
701:
688:
663:
656:
625:
600:
560:
519:
494:
462:
439:
418:(2): 180–190.
398:
354:
347:
328:
326:
323:
283:
280:
277:
276:
249:hyperviscosity
245:
238:
234:
233:
182:
173:
169:
168:
165:varicose veins
157:
150:
146:
145:
142:
139:
129:
126:
122:Rudolf Virchow
112:
111:
105:
99:
51:
50:
47:
41:
40:
36:
35:
27:
26:
18:
15:
9:
6:
4:
3:
2:
1419:
1408:
1405:
1403:
1400:
1398:
1395:
1394:
1392:
1371:
1368:
1367:
1365:
1361:
1360:Hematosalpinx
1358:
1356:
1353:
1351:
1348:
1346:
1343:
1341:
1338:
1337:
1335:
1331:
1328:
1326:
1323:
1321:
1318:
1317:
1315:
1311:
1308:
1306:
1303:
1301:
1298:
1296:
1293:
1291:
1288:
1287:
1285:
1284:
1282:
1278:
1270:
1267:
1266:
1265:
1262:
1260:
1257:
1255:
1252:
1250:
1247:
1245:
1242:
1241:
1239:
1235:
1225:
1222:
1220:
1217:
1215:
1212:
1210:
1207:
1205:
1202:
1200:
1197:
1195:
1192:
1190:
1187:
1183:
1180:
1178:
1175:
1173:
1170:
1169:
1168:
1165:
1164:
1162:
1160:
1156:
1148:
1145:
1143:
1140:
1139:
1138:
1137:
1133:
1129:
1126:
1125:
1124:
1121:
1117:
1114:
1113:
1112:
1109:
1108:
1106:
1104:
1100:
1094:
1091:
1089:
1086:
1085:
1080:
1077:
1075:
1072:
1071:
1070:
1067:
1063:
1060:
1059:
1058:
1054:
1051:
1050:
1048:
1046:
1042:
1039:
1035:
1032:
1028:
1018:
1015:
1013:
1010:
1006:
1003:
1001:
998:
996:
993:
991:
988:
986:
985:Louvel's sign
983:
981:
980:Lisker's sign
978:
976:
973:
971:
968:
967:
966:
963:
962:
960:
956:
950:
947:
945:
942:
940:
937:
935:
932:
930:
929:Thrombophilia
927:
926:
924:
922:
918:
912:
909:
905:
902:
901:
900:
897:
893:
890:
888:
885:
883:
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878:
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871:
868:
866:
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861:
858:
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853:
851:
848:
846:
843:
842:
841:
838:
837:
835:
831:
828:
824:
818:
815:
813:
810:
808:
805:
804:
801:
797:
793:
790:Disorders of
785:
780:
778:
773:
771:
766:
765:
762:
753:
747:
733:on 2016-03-03
732:
728:
722:
716:
715:Who Named It?
712:
711:
705:
698:
692:
678:on 2016-03-04
677:
673:
667:
659:
657:0-88135-113-X
653:
649:
642:
638:
637:
629:
615:on 2016-03-03
614:
610:
604:
590:on 2016-03-05
586:
582:
578:
571:
564:
556:
552:
547:
542:
538:
534:
530:
523:
509:on 2016-03-05
508:
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484:
469:
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266:
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243:
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231:
227:
223:
220:of activated
219:
215:
211:
207:
203:
199:
195:
191:
187:
183:
181:
177:
174:
171:
170:
166:
162:
161:venous stasis
158:
156:
155:
151:
148:
147:
143:
140:
137:
136:
133:
125:
123:
120:
117:
109:
106:
103:
100:
98:
95:
94:
93:
91:
85:
61:
57:
48:
46:
42:
37:
33:
28:
23:
1370:Hemarthrosis
1134:
1122:
1110:
1000:Pratt's sign
943:
812:coagulopathy
751:
746:
735:. Retrieved
731:the original
721:
708:
704:
696:
691:
680:. Retrieved
676:the original
666:
647:
635:
628:
617:. Retrieved
613:the original
603:
592:. Retrieved
585:the original
580:
576:
563:
536:
532:
522:
511:. Retrieved
507:the original
497:
472:. Retrieved
452:
415:
411:
401:
374:
370:
338:
332:
316:
292:
285:
253:antithrombin
240:
206:biomaterials
194:hypertension
190:shear stress
179:
175:
152:
131:
113:
59:
55:
54:
1123:aggregation
1005:Rose's sign
975:Homans sign
807:Coagulation
750:Aschoff L.
695:Wiseman R.
186:endothelium
108:Endothelial
102:Hemodynamic
1397:Hematology
1391:Categories
1355:Hematocele
1320:Hemothorax
1295:Hemoptysis
1167:Hemophilia
939:Thrombosis
737:2009-02-10
682:2009-02-10
619:2009-02-10
594:2012-05-09
513:2009-02-10
474:2021-12-06
325:References
297:, whereby
288:thrombosis
138:Virchow's
90:thrombosis
49:thrombosis
1345:Hemobilia
1290:Epistaxis
877:Platelets
710:synd/1223
483:cite book
263:or burn,
226:monocytes
222:platelets
218:membranes
128:The triad
119:physician
1336:abdomen
1259:Petechia
1254:Hematoma
1244:Bleeding
1111:adhesion
1037:By cause
1030:Bleeding
934:Thrombus
833:By cause
826:Clotting
796:clotting
792:bleeding
555:15692259
468:Archived
434:18783400
393:15692260
210:implants
202:bacteria
1305:Hyphema
1280:By site
1264:Purpura
958:By site
299:thrombi
282:History
269:obesity
141:Modern
58:or the
1366:joint
1316:torso
1249:Bruise
1172:A/VIII
654:
553:
460:
432:
391:
345:
312:eponym
265:cancer
261:trauma
154:Stasis
144:Notes
116:German
1286:head
921:Clots
643:–226.
588:(PDF)
573:(PDF)
303:veins
1182:C/XI
1177:B/IX
794:and
652:ISBN
551:PMID
489:link
458:ISBN
430:PMID
389:PMID
343:ISBN
1074:TTP
1057:ITP
899:DIC
713:at
641:219
541:doi
420:doi
416:143
379:doi
228:in
212:or
208:of
192:or
178:or
75:ɪər
1393::
1069:TM
1055::
581:81
579:.
575:.
549:.
537:33
535:.
531:.
485:}}
481:{{
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442:^
428:.
414:.
410:.
387:.
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373:.
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357:^
232:.
216:,
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81:oʊ
783:e
776:t
769:v
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597:.
557:.
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491:)
477:.
436:.
422::
395:.
381::
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