Thrombosis may involve different parts of the MCS, any of which requires specific treatment. Blood flow may be disturbed at different levels of the LVAD system, such as obstruction of the inflow cannula by ingested thrombus (prepump thrombosis), thrombus trapped between the impeller and the housing (intrapump thrombosis) and kinking or stenosis of the outflow graft (post-pump thrombosis). Outflow graft occlusion may be due to stenosis, thrombosis or torsion and may lead to gradual reductions in flow and eventual flow cessation with consequent HF symptoms or death [419, 420].