Vascular Function in Hemostasis

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Abstract
All components of the hemostatic system are confined within a closed network of vessels in the body, that is, the vascular tree. This system of arteries, capillaries, and veins was originally thought to function simply as conduits for the transport of blood, 1 and vasoconstriction, 2 a means of maintaining the blood within the system. This response to trauma was attributed to the inherent irritability 3 of living tissues and/or their response to “vasoactive” substances. 4 Current reports indicate that vascular contribution to the hemostatic process is more complex than simple vasoconstriction in response to trauma. The endothelial lining of the system acts as an inert shield between the potentially thrombotic blood proteins and platelets and the procoagulant-acting subendothelial layers. Traumatic disruption of this barrier permits contact between blood and the subendothelium, which, in addition to vasoconstriction, stimulates the processes of platelet aggregation and coagulation. This chapter briefly details current knowledge of vascular function as it relates to hemostasis.

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