Athrombus is defined as an accumulation of platelets, fibrin, and other clotting factors that lodges in an artery or a vein and occludes blood flow.1,(p1193),2 Blood coagulation occurs via both intrinsic and extrinsic pathways (Figure 1). Four conditions can cause a thrombus: venous stasis, vessel damage or injury, inflammation, and hypercoagulability.2,5 Deep venous thrombosis causes pain and swelling in the affected extremity, and the thrombus can dislodge and can lead to a potentially fatal pulmonary embolism.2,6 Arterial occlusion can lead to pain and ischemia and potentially to amputation because of the lack of arterial blood flow distal to the occlusion.2
Because of the seriousness of peripheral vascular occlusions, prompt treatment is critical. Traditionally, patients with deep venous thrombosis have been treated with intravenous infusions of heparin and then with oral warfarin after discharge from the hospital.7 Patients with arterial...