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Hemostasis is a process by which the body repairs damage to a blood vessel wall to prevent hemorrhage. At the site of injury, a hemostatic plug is formed by the interaction of the vessel wall, platelets, and coagulation factors. As the plug is formed, the coagulation system generates thrombin from prothrombin, thus initiating the formation of a fibrin clot (Fig. 1). This system is well controlled by multiple modulators and inhibitors at each step in the pathway. The major trigger for coagulation is the exposure of tissue factor (TF) in the injured vessel wall. TF binding to Factor VII (FVII), along with calcium and platelet-derived phospholipids, activates FX. FX, in conjunction with FV, prothrombin, calcium, and phospholipids, generates thrombin. Thrombin can initiate further thrombin production by the contact factor cascade (intrinsic pathway). It also converts fibrinogen to fibrin and activates...

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