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A blood clot occurring on the wall of a blood vessel where the endothelium is damaged.



a clot of blood formed during the lumen of a blood vessel or in the heart. In a broader sense, extravascular clots of blood that form during bleeding, as well as clots of lymph in the lymphatics are also called thrombi.

The formation of a thrombus consists of the following stages: agglutination of platelets, coagulation of fibrinogen, agglutination of red blood cells, and precipitation of plasma proteins. Thrombi may be white, red, laminated, or hyaline. A white thrombus consists of platelets, fibrin, and white blood cells and is formed slowly during rapid blood flow, generally in arteries. A red thrombus, in which red blood cells predominate, forms rapidly during slow blood flow, generally in veins. The most common type of thrombus is the laminated thrombus, which has a layered structure and crimped surface and contains fragments of white and red thrombi. It is attached to the endothelium of a blood vessel, generally that of a vein; this differentiates it from a postmortem thrombus. A hyaline thrombus forms in blood vessels of the capillary bed and consists of a homogenized mass of protein.

A thrombus may be parietal or obstructive. A parietal thrombus forms within the heart in endocarditis and heart disease, in large arteries in atherosclerosis, and in veins in thrombophlebitis. As a parietal thrombus grows, it becomes obstructive, generally in small arteries and veins. A thrombus that grows rapidly into the lumen of a vessel is called progressive, and one that originates in cardiac insufficiency is called congestive. A thrombus that forms in aneurysms is called dilatational; one that is unattached within an atrium is called spherical. A thrombus can dissolve or can grow connective tissue, a process called organization. Thin-walled blood vessels may appear in this tissue (canalization), or calcium salts may be deposited (calcification). A thrombus may cause an embolism or may become purulent, a condition accompanied by a thrombobacterial embolism and leading to sepsis.