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Abstract Hemostasis preserves vascular integrity by balancing the physiologic processes that maintain blood in a fluid state under normal circumstances and prevent excessive bleeding after vascular injury. Preservation of blood fluidity depends on an intact vascular endothelium and a complex series of regulatory pathways that maintains platelets in a quiescent state and keeps the coagulation system in equilibrium. In contrast, arrest of bleeding requires rapid formation of hemostatic plugs at sites of vascular injury to prevent exsanguination. Perturbation of hemostasis can lead to bleeding or thrombosis. Bleeding will occur if there is failure to seal vascular leaks either because of defective hemostatic plug formation or because of premature breakdown of the plugs |