Role of high shear rate in thrombosis

J Vasc Surg. 2015 Apr;61(4):1068-80. doi: 10.1016/j.jvs.2014.12.050. Epub 2015 Feb 19.


Acute arterial occlusions occur in high shear rate hemodynamic conditions. Arterial thrombi are platelet-rich when examined histologically compared with red blood cells in venous thrombi. Prior studies of platelet biology were not capable of accounting for the rapid kinetics and bond strengths necessary to produce occlusive thrombus under these conditions where the stasis condition of the Virchow triad is so noticeably absent. Recent experiments elucidate the unique pathway and kinetics of platelet aggregation that produce arterial occlusion. Large thrombi form from local release and conformational changes in von Willebrand factor under very high shear rates. The effect of high shear hemodynamics on thrombus growth has profound implications for the understanding of all acute thrombotic cardiovascular events as well as for vascular reconstructive techniques and vascular device design, testing, and clinical performance.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Arterial Occlusive Diseases / blood
  • Arterial Occlusive Diseases / physiopathology*
  • Arterial Occlusive Diseases / therapy
  • Arteries / physiopathology*
  • Biomechanical Phenomena
  • Blood Coagulation
  • Blood Flow Velocity
  • Blood Platelets / metabolism
  • Hemodynamics*
  • Humans
  • Kinetics
  • Models, Cardiovascular
  • Platelet Aggregation
  • Regional Blood Flow
  • Stress, Mechanical
  • Thrombosis / blood
  • Thrombosis / physiopathology*
  • Thrombosis / therapy
  • Vascular Patency
  • von Willebrand Factor / metabolism


  • von Willebrand Factor