{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T01:45:10Z","timestamp":1776908710197,"version":"3.51.2"},"reference-count":129,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2020,7,18]],"date-time":"2020-07-18T00:00:00Z","timestamp":1595030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>According to a widespread theory, thrombotic masses are not formed in the pulmonary artery (PA) but result from migration of blood clots from the venous system. This concept has prevailed in clinical practice for more than a century. However, a new technologic era has brought forth more diagnostic possibilities, and it has been shown that thrombotic masses in the PA could, in many cases, be found without any obvious source of emboli. Chronic obstructive pulmonary disease, asthma, sickle cell anemia, emergency and elective surgery, viral pneumonia, and other conditions could be complicated by PA thrombosis development without concomitant deep vein thrombosis (DVT). Different pathologies have different causes for local PA thrombotic process. As evidenced by experimental results and clinical observations, endothelial and platelet activation are the crucial mechanisms of this process. Endothelial dysfunction can impair antithrombotic function of the arterial wall through downregulation of endothelial nitric oxide synthase (eNOS) or via stimulation of adhesion receptor expression. Hypoxia, proinflammatory cytokines, or genetic mutations may underlie the procoagulant phenotype of the PA endothelium. Both endotheliocytes and platelets could be activated by protease mediated receptor (PAR)- and receptors for advanced glycation end (RAGE)-dependent mechanisms. Hypoxia, in particular induced by high altitudes, could play a role in thrombotic complications as a trigger of platelet activity. In this review, we discuss potential mechanisms of PA thrombosis in situ.<\/jats:p>","DOI":"10.3390\/ijms21145086","type":"journal-article","created":{"date-parts":[[2020,7,20]],"date-time":"2020-07-20T06:08:17Z","timestamp":1595225297000},"page":"5086","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Pulmonary Artery Thrombosis: A Diagnosis That Strives for Its Independence"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3537-7409","authenticated-orcid":false,"given":"Olga","family":"Porembskaya","sequence":"first","affiliation":[{"name":"Mechnikov North-Western State Medical University, Saint Petersburg 191015, Russia"},{"name":"Institute of Experimental Medicine, Saint Petersburg 197376, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yana","family":"Toropova","sequence":"additional","affiliation":[{"name":"Institute of Experimental Medicine, Almazov National Medical Research Center, Saint Petersburg 197341, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vladimir","family":"Tomson","sequence":"additional","affiliation":[{"name":"Pavlov University, Saint Petersburg 197022, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5358-7218","authenticated-orcid":false,"given":"Kirill","family":"Lobastov","sequence":"additional","affiliation":[{"name":"Pirogov Russian National Research Medical University, Moscow 117997, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonid","family":"Laberko","sequence":"additional","affiliation":[{"name":"Pirogov Russian National Research Medical University, Moscow 117997, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viacheslav","family":"Kravchuk","sequence":"additional","affiliation":[{"name":"Mechnikov North-Western State Medical University, Saint Petersburg 191015, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergey","family":"Saiganov","sequence":"additional","affiliation":[{"name":"Mechnikov North-Western State Medical University, Saint Petersburg 191015, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Brill","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham B152TT, UK"},{"name":"Department of Pathophysiology, Sechenov First Moscow State Medical University (Sechenov University), Moscow 119991, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"168","DOI":"10.3121\/cmr.2009.866","article-title":"Virchow\u2019s contribution to the understanding of thrombosis and cellular biology","volume":"8","author":"Kumar","year":"2010","journal-title":"Clin. 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