Blood clot formation occurs in response to tissue injury causing vasoconstriction followed by the adhesion and aggregation of platelets. Clot stabilization finalizes by fibrin formation through a cascade of clotting factors. Intravessel blood clots may be arterial or venous.43 Arterial thrombi occur when platelet aggregation, fibrin, and erythrocytes aggregate at sites in arteries. This can lead to occlusion of the arteries and subsequent tissue ischemia. Disruption of the thromboemoblus and movement to smaller vessels can cause myocardial infarction or cerebrovascular events.43,44,45 Venous thrombi develop in areas with slow or irregular blood flow. They may cause occlusion at the local site. However, a greater danger associated with venous thromboemboli is their ability to travel and cause deep vein thromobosis and/or pulmonary thrombosis.46
Approximately 795,000 people in the United States suffer a stroke each year and, of those, approximately 140,000 will die.47 Stroke is also the leading cause of long-term disability in the U.S.47 Many patients who have had a thromboembolic event and/or who are at risk for future thromboemboli are treated with antithrombotic (prevent thrombus formation) and anticoagulant agents (prevent clot stabilization and coagulation).44-46 It is important that clinicians have a complete understanding of the mechanisms of action of the medications patients are taking. Consulting with the patients’s treating physician can allow for safe dental treatment.
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