Emerging Use of Viscoelastography in Thrombosis 
and Hemostasis: A Challenge to Conventional Coagulation Tests?—Part II: The Use of Thromboelastography and Thromboelastometry in the Assessment of Clinical Disorders

Kwaan, Hau C.; Lindholm, Paul F.; Othman, Marth; Walsh, Mark

doi:10.1055/s-0042-1758061

Cited by 2 publications

(2 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Viscoelastic tests, which are performed on a whole blood sample and offer a holistic view of ex vivo coagulation, provide results within minutes and can therefore be viewed and evaluated at the point-of-care. 53 The most established of these tests are thromboelastography (TEG 5000) and rotational thromboelastometry (ROTEM delta). 53 In TEG, whole blood and clotting activators are mixed in a disposable cup heated to 37 °C and subjected to slow periodic and alternating rotations.…”

Section: Viscoelastic Assaysmentioning

confidence: 99%

“…53 The most established of these tests are thromboelastography (TEG 5000) and rotational thromboelastometry (ROTEM delta). 53 In TEG, whole blood and clotting activators are mixed in a disposable cup heated to 37 °C and subjected to slow periodic and alternating rotations. A disposable plastic pin, suspended in the center of the cup, is enveloped by the developing clot.…”

Section: Viscoelastic Assaysmentioning

confidence: 99%

See 1 more Smart Citation

Utility of Global Hemostatic Assays in Patients with Bleeding Disorders of Unknown Cause

Mehic,

Assinger,

Gebhart

2024

Hamostaseologie

View full text Add to dashboard Cite

Bleeding disorder of unknown cause (BDUC) is a diagnosis of exclusion after exhaustive evaluation of plasmatic coagulation and platelet function. This review explores the utility of global hemostatic assays as confirmatory tests and in elucidating the pathophysiology of BDUC. Unlike traditional hemostatic tests that focus on coagulation factors, global assays are conducted both in plasma and also whole blood. These assays provide a more comprehensive understanding of the cell-based model of coagulation, aid in the identification of plasmatic factor abnormalities that may reduce hemostatic capacity, and allow for the assessment of impaired platelet–endothelial interactions under shear stress, as well as hyperfibrinolytic states. While clinical tests such as skin bleeding time and global assays such as PFA-100 exhibit limited diagnostic capacity, the role of viscoelastic testing in identifying hemostatic dysfunction in patients with BDUC remains unclear. Thrombin generation assays have shown variable results in BDUC patients; some studies demonstrate differences compared with healthy controls or reference values, whereas others question its clinical utility. Fibrinolysis assessment in vitro remains challenging, with studies employing euglobulin clot lysis time, plasma clot lysis time, and fluorogenic plasmin generation yielding inconclusive or conflicting results. Notably, recent studies suggest that microfluidic analysis unveils shear-dependent platelet function defects in BDUC patients, undetected by conventional platelet function assays. Overall, global assays might be helpful for exploring underlying hemostatic impairments, when conventional hemostatic laboratory tests yield no results. However, due to limited data and/or discrepant results, further research is needed to evaluate the utility of global assays as screening tools.

show abstract

Section: Viscoelastic Assaysmentioning

confidence: 99%

Section: Viscoelastic Assaysmentioning

confidence: 99%