Under physiological conditions, peripheral arteries release endogenous vascular-protective and antithrombotic
agents. Endothelial cells actively synthesize vasoactive mediators, which regulate vascular tone and
platelet reactivity thus preventing thrombosis. Atherosclerosis disrupts homeostasis and favours thrombosis by
triggering pro-thrombotic responses in the vessels, platelet activation, aggregation as well as vasoconstriction,
phenomena that ultimately lead to symptomatic lumen restriction or complete occlusion.
In the present review, we will discuss the homeostatic role of arterial vessels in releasing vascular-protective
agents, such as nitric oxide and prostacyclin, the role of pro- and anti-thrombotic vascular receptors as well as
the contribution of circulating platelets and coagulation factors in triggering the pro-thrombotic response(s). We
will discuss the pathological consequences of disrupting the protective pathways in the arteries and the pharmacological
interventions along these pathways.