Marlies Ledford-Kraemer, MBA, BS, MT(ASCP)SH · Marlies Ledford-Kraemer, MBA, BS, MT(ASCP)SH FibrinolyticPathway Revised: mmiiii ... TFPI Inhibitor FV a Activated Factor V FX a Activated

Marlies Ledford-Kraemer, MBA, BS, MT(ASCP)SH

FibrinolyticFibrinolytic PathwayPathway

Revised: mmiiiiwww.CLOT-ED.com

On Adobe toolbar, click down & choose “Fit Page” for correct viewing sizeSlide 3 provides you with a legend for all symbols used in the pathway slides that followSlide 4 shows you the entire pathway to be featured in this seriesThe remainder of the slides show you the pathway in sequential order so that you can follow each step in the process

Advance slides slowly to closely follow each additionAdvance slides quickly and you will be able to see a “cascading” effect

2

How to Use These Slides100%

Legend

3Tissue Factor Pathway InhibitorTFPI

Activated Factor VFVa

Activated FXFXa

Factor XFX

Activated Factor VIIIFVIIIa

Activated FIXFIXa

Factor IXFIX

Activated FXIFXIa

Factor XIFXI

High Molecular Weight KininogenHMWK

Activated FXIIFXIIa

Factor XIIFXII

NameSymbol

ThrombomodulinTM

“converts”, “gives rise to”, “yields”

Inhibits

Activated TAFITAFIa

Protein CPC

Plasminogen Activator Inhibitor-1PAI-1

Tissue Plasminogen ActivatortPA

Factor XIIIFXIII

Inhibited by APC

Activated Protein CAPC

Thrombin ActivatableFibrinolysis InhibitorTAFI

NameSymbol

‡

FibrinolysisFibrinolysis

FIBRINFIBRIN

Plasmin

Plasminogen

‡tPA

PAI-1FXIII

‡

Thrombin

PC APCTMThrombinProthrombin

Va

X

Xa

IX

IXa

IX

Thrombin

XIa

XI

XIIa

XII

Surface

HM

WK

Prekallikrein

Fibrinogen

VIIaTF

InjuryVessel

‡

‡ VIIIaX

TFPI

TAFI

TAFIa

Thrombin

Adapted from Broze, Semin Hematol 1992;29:159-69

ThrombinProthrombin

Va

X

Xa

IX

IXa

IX

Thrombin

XIa

XI

XIIa

XII

Surface

HM

WK

Prekallikrein

Fibrinogen

VIIaTF

InjuryVessel

‡

‡ VIIIaX

TFPI

TAFI

TAFIa

Thrombin

FIBRINFIBRIN

ThrombinProthrombin

Va

X

Xa

IX

IXa

IX

Thrombin

XIa

XI

XIIa

XII

Surface

HM

WK

Prekallikrein

Fibrinogen

VIIaTF

InjuryVessel

‡

‡ VIIIaX

TFPI

TAFI

TAFIa

Thrombin

FIBRINFIBRIN

FXIII

ThrombinProthrombin

Va

X

Xa

IX

IXa

IX

Thrombin

XIa

XI

XIIa

XII

Surface

HM

WK

Prekallikrein

Fibrinogen

VIIaTF

InjuryVessel

‡

‡ VIIIaX

TFPI

TAFI

TAFIa

Thrombin

FIBRINFIBRIN Plasminogen

FXIII

ThrombinProthrombin

Va

X

Xa

IX

IXa

IX

Thrombin

XIa

XI

XIIa

XII

Surface

HM

WK

Prekallikrein

Fibrinogen

VIIaTF

InjuryVessel

‡

‡ VIIIaX

TFPI

TAFI

TAFIa

Thrombin

FIBRINFIBRIN Plasminogen

tPAFXIII

ThrombinProthrombin

Va

X

Xa

IX

IXa

IX

Thrombin

XIa

XI

XIIa

XII

Surface

HM

WK

Prekallikrein

Fibrinogen

VIIaTF

InjuryVessel

‡

‡ VIIIaX

TFPI

TAFI

TAFIa

Thrombin

FIBRINFIBRIN

Plasmin

Plasminogen

tPAFXIII

ThrombinProthrombin

Va

X

Xa

IX

IXa

IX

Thrombin

XIa

XI

XIIa

XII

Surface

HM

WK

Prekallikrein

Fibrinogen

VIIaTF

InjuryVessel

‡

‡ VIIIaX

TFPI

TAFI

TAFIa

Thrombin

FIBRINFIBRIN

Plasmin

Plasminogen

tPAFXIII

ThrombinProthrombin

Va

X

Xa

IX

IXa

IX

Thrombin

XIa

XI

XIIa

XII

Surface

HM

WK

Prekallikrein

Fibrinogen

VIIaTF

InjuryVessel

‡

‡ VIIIaX

TFPI

TAFI

TAFIa

Thrombin

FibrinolysisFibrinolysis

FIBRINFIBRIN

Plasmin

Plasminogen

tPAFXIII

ThrombinProthrombin

Va

X

Xa

IX

IXa

IX

Thrombin

XIa

XI

XIIa

XII

Surface

HM

WK

Prekallikrein

Fibrinogen

VIIaTF

InjuryVessel

‡

‡ VIIIaX

TFPI

TAFI

TAFIa

Thrombin

FibrinolysisFibrinolysis

FIBRINFIBRIN

Plasmin

Plasminogen

tPAFXIII

ThrombinProthrombin

Va

X

Xa

IX

IXa

IX

Thrombin

XIa

XI

XIIa

XII

Surface

HM

WK

Prekallikrein

Fibrinogen

VIIaTF

InjuryVessel

‡

‡ VIIIaX

TFPI

TAFI

TAFIa

Thrombin

FibrinolysisFibrinolysis

FIBRINFIBRIN

Plasmin

Plasminogen

tPAPAI-1FXIII

ThrombinProthrombin

Va

X

Xa

IX

IXa

IX

Thrombin

XIa

XI

XIIa

XII

Surface

HM

WK

Prekallikrein

Fibrinogen

VIIaTF

InjuryVessel

‡

‡ VIIIaX

TFPI

TAFI

TAFIa

Thrombin

FibrinolysisFibrinolysis

FIBRINFIBRIN

Plasmin

Plasminogen

tPAPAI-1FXIII

‡

Thrombin

PC APCTMThrombinProthrombin

Va

X

Xa

IX

IXa

IX

Thrombin

XIa

XI

XIIa

XII

Surface

HM

WK

Prekallikrein

Fibrinogen

VIIaTF

InjuryVessel

‡

‡ VIIIaX

TFPI

TAFI

TAFIa

Thrombin

FibrinolysisFibrinolysis

FIBRINFIBRIN

Plasmin

Plasminogen

‡tPA

PAI-1FXIII

‡

Thrombin

PC APCTMThrombinProthrombin

Va

X

Xa

IX

IXa

IX

Thrombin

XIa

XI

XIIa

XII

Surface

HM

WK

Prekallikrein

Fibrinogen

VIIaTF

InjuryVessel

‡

‡ VIIIaX

TFPI

TAFI

TAFIa

Thrombin