Kazan medical journalKazan medical journal0368-48142587-9359Eco-Vector1051810.17816/KMJ2018-994Research ArticleA case of arterial thrombosis with formation of an atypical fibrin-rich thrombusKhismatullinR Rrafael.khismatullin@gmail.comShakirovaA Zrafael.khismatullin@gmail.comPeshkovaA Drafael.khismatullin@gmail.comKhuziakhmedovA Nrafael.khismatullin@gmail.comKhizrievS Mrafael.khismatullin@gmail.comLitvinovR Irafael.khismatullin@gmail.comKazan State Medical UniversityDepartmental Clinical Hospital of Station KazanKazan (Volga Region) Federal UniversityCity Clinical Hospital № 7University of Pennsylvania School of Medicine2511201899699499726112018Copyright © 2018, Khismatullin R.R., Shakirova A.Z., Peshkova A.D., Khuziakhmedov A.N., Khizriev S.M., Litvinov R.I.2018<p><strong>Aim.</strong> To describe a case of arterial thrombosis with a thrombus that had atypical composition due to profound pathological changes in the cellular and protein composition of the blood.</p>
<p><strong>Methods.</strong> Scanning electron microscopy of an ex vivo thrombus extracted from the common femoral artery.</p>
<p><strong>Results.</strong> In the absence of platelets and leukocytes there was a significant prevalence of fibrin over other blood components in all layers of the arterial thrombus. There were no morphological signs of intravital contraction (retraction) characteristic for thrombi: single erythrocytes were not exposed compressive deformation, redistribution of fibrin and platelets within the thrombus toward the periphery. Formation of the atypical arterial thrombus in the vessel with atherosclerotic vessel damage is probably due to association with severe hyperfibrinogenemia and thrombocytopenia.</p>
<p><strong>Conclusion.</strong> The structure of a thrombus depends not only on its vascular location (arterial or venous), but also on the cellular and protein composition of the blood. These factors support diversification of antithrombotic therapy, considering composition and properties of thrombi irrespective of the place and hemodynamic conditions of their formation.</p>arterial thrombusfibrinартериальный тромбфибрин[Shida Y., Rydz N., Stegner D., et al. Analysis of the role of von Willebrand factor, platelet glycoprotein VI-, and α2β1-mediated collagen binding in thrombus formation. Blood. 2014; 124 (11): 1799–1807. DOI: 10.1182/blood-2013-09-521484.][Koupenova M., Kehrel B.E., Corkrey H.A., et al. Thrombosis and platelets: an update. Eur. Heart J. 2017; 38: 785–791. DOI: 10.1093/eurheartj/ehw55.][Silvain J., Collet J.P., Nagaswami C., et al. Composition of coronary thrombus in acute myocardial infarction. J. Am. Coll. Cardiol. 2011; 57 (12): 1359–1367. DOI: 10.1016/j.jacc.2010.09.077.][Litvinov R.I., Khismatullin R.R., Shakirova A.Z., et al. Morphological signs of intravital contraction (retraction) of pulmonary thrombotic emboli. BioNanoScience. 2017; 8 (1): 428–433. DOI: 10.1007/s12668-017-0476-1.][Cines D.B., Lebedeva T., Nagaswami C., et al. Clot contraction: compression of erythrocytes into tightly packed polyhedra and redistribution of platelets and fibrin. Blood. 2013; 123 (10): 1596–1603. DOI: 10.1182/blood-2013-08-523860.][Tutwiler V., Litvinov R.I., Lozhkin A.P., et al. Kinetics and mechanics of clot contraction are governed by the molecular and cellular composition of the blood. Blood. 2015; 127 (1): 149–159. DOI: 10.1182/blood-2015-05-647560.][Tutwiler V., Wang H., Litvinov R.I., et al. Interplay of platelet contractility and elasticity of fibrin/erythrocytes in blood clot retraction. Biophysical Journal. 2017; 112 (4): 714–723. DOI: 10.1016/j.bpj.2017.01.005.]