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Quoting from _Robbins Basic Pathology 9th ed.

Thrombi are focally attached to the underlying vascular surface and tend to propagate toward the heart; thus, arterial thrombi grow in a retrograde direction from the point of attachment, while venous thrombi extend in the direction of blood flow.

What’s the underlying mechanism of this retrograde propagation? Shouldn’t the blood flow cause the thrombus to propagate away from the heart in case of arteries? If not, then what explains the difference in propagation direction between arteries and veins?

user13785
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    Welcome user13785, very good questions! – DoctorWhom May 17 '18 at 19:17
  • Thanks @DoctorWhom. No answers though. – user13785 May 18 '18 at 18:11
  • Currently there is a paucity of experts participating, but we are working on a site transformation gearing it towards professionals/students of medical sciences. We hope to foster an environment for these sort of questions! Please stick around and join in! I genuinely don't know the answer to this question myself or I would answer, and don't have time to research it atm. – DoctorWhom May 21 '18 at 03:32
  • "away from the heart in case of arteries" - I can see what you mean, but it is still traveling toward the heart when you think about it. Your definition and understanding of veins and arteries are correct. – Andrew Jul 25 '20 at 08:19

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In case of an arterial thrombus, assume that it is occluding the vessel wall. This means downstream of the thrombus blood flow is reduced, but upstream the blood flow becomes turbulent much like the barricades holding up water released from the top of a dam. Arterial thrombus is usually caused by turbulent blood flow and endothelial injury. Therefore the retrograde propagation. This is what I think.

user28773
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    Welcome, and nice answer. As you're new on this site, please know that reliable sources are required for answers (and usually questions as well, but the site, though strict, is not as strict with questions). The post notice is not because your answer is inaccurate, but because there is no source cited to back it up. – anongoodnurse Jan 17 '24 at 21:22