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The role of nanomedicine in the imaging and therapy of thrombosis.

Hemostasis is the mechanism by which the body prevents blood loss. In its absence, even the smallest trauma would result in the need for immediate intervention to prevent life-threatening hemorrhage, as is seen in coagulation disorders, such as hemophilia. Thus, the formation of blood clots (thrombi) within vessels is a beneficial process as it prevents blood loss. However, in contradistinction to its beneficial effects to limit uncontrolled bleeding, exaggerated clotting can lead to pathological thrombus formation, which, depending on its location, may result in significant morbidity and mortality. Over a century ago, Virchow described three underlying factors in the pathogenesis of thrombosis: stasis, hypercoaguability and vascular injury. On the arterial side, thrombosis (often superimposed on athero sclerotic lesions and usually platelet rich) leads to end-organ ischemia, causing syndromes such as stroke, myocardial infarction and sudden cardiac death. On the venous side, red blood cell- and fibrin-rich thrombi cause the highly morbid deep venous thrombosis syndromes, as well as the potentially fatal syndrome of pulmonary embolism. Regardless of arterial or venous origin, the rapid diagnosis and treatment of pathological thrombosis is of the utmost importance, as restoration of vascular patency is associated with the best prognosis. In this regard, targeted nanomaterials may serve as excellent platforms on which to develop multifunctional agents for the unified detection and treatment of this disease.