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Understand Virchow's Triad to risk-stratify and prevent venous thrombosis and pulmonary embolism

By John Joseph Pack MD

Published on 05/10/2026

Rudolf Virchow was a German physician, scientist, historian, and anthropologist.  As a pathologist, he closely studied venous thromboembolism, and his findings were foundational to our knowledge.  He was one of the first physicians to describe a pathological process at the cellular level, which he surmised from his keen observational skills.  Virchow demonstrated that venous thrombosis is derived from three factors:  Venous stasis, vascular/endothelial injury or trauma, and hypercoagulability. 

The following conditions can precipitate the thrombogenic cascade:  Surgery, Trauma, Prolonged Immobility, Malignancy, Pregnancy, Congestive Heart Failure, Varicose Veins, Obesity, Advanced Age, and History of DVT or PE. 

Recognizing these risk factors is important to prevent or consider the diagnosis of deep venous thrombosis and venous thromboembolism.   

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