Mathematical Models for Blood Coagulation - Fluid-Structure Interaction and Biomedical Applications - page 501

• More disorders due to factors deficiency or malfunction. They all cause

thrombophilia and are usually rare or very rare. We omit listing them for the
sake of brevity.

7.5.3 Disorders Due to Proteins C, S, Z or to Vitamin K

Deficiency

• Protein C deficiency.

• Protein S deficiency.

• Protein Z deficiency.

Due to the anticoagulant actions of PC, PS, PZ deficiency in each of these proteins
predisposes to thrombophilia. They are rare. We quote [ 57 ].

• Vitamin K deficiency. Induced by warfarin treatment or (rarely) occurring

naturally. We have already discussed its consequences.

We omit mentioning disorders linked to other serpins deficiencies and to fibrinolysis
factors deficiencies, since they are very rare.

7.5.4 Deep Vein (or Venous) Thrombosis (DVT)

Blood stasis or significantly reduced circulation in limbs is known to be responsible
of clot formation in deep veins, particularly in the large veins in the legs (femoral,
popliteal, saphenous, etc.). 51 It can also affect deep veins of the pelvis and more
rarely in the arms (succlavian or axillary veins). 52 It causes swelling and it may
cause pulmonary embolism. For that reason it has to be treated as soon as possible
with strong anticoagulants. 53 A typical consequence is a permanent damage of
vein valves. 54 Altered circulation can produce conditions favorable to clotting
particularly in the valves pocket.
Clot formation in the absence of lesions and in an environment of reduced
stress is difficult to explain on the basis of the cell-based model, since the process
has a clear intrinsic origin. It is out of question that fibrin production requires

51 Because immobilization is a frequent cause, DVT is also called the economy class syndrome ,
since many cases have been reported in passengers after long flights.
52 In that case it is known as Paget-Schrötter disease .
53 Not with fibrinolytic proteins (like tPA or UPA), because they could fragment rather than
gradually dissolve the clot. Fibrinolytic therapies are instead used to attack arterial thrombosis
in the heart or the brain.
54 Major veins are provided with valves preventing flux inversion, thus helping circulation in the
presence of reduced pressure gradients.