Thromboelastography: a review for radiologists and implications on periprocedural bleeding risk

Abstract

Thromboelastography (TEG) and rotational thromboelastometry are emerging technologies that are gaining increasing acceptance in the medical field to evaluate the coagulation status of patients on an individual level by assessing dynamic clot formation. TEG has been proven to reduce blood product use as well as improve patient outcomes in a variety of medical settings, including trauma and surgery due to the expediated nature of the test as well as the ability to determine specific deficiencies present in whole blood that are otherwise undetectable with traditional coagulation studies. Currently, no guidelines or recommendations are in place for the utilization of TEG in interventional or diagnostic radiology although access to TEG has become increasingly common in recent years. This manuscript presents a review of prior literature on the technical aspects of TEG as well as its use in various fields and explains the normal TEG-tracing parameters. Common hemodynamic abnormalities and their effect on the TEG tracing are illustrated, and the appropriate treatments for each abnormality are briefly mentioned. TEG has the potential to be a useful tool for determining the hemodynamic state of patients in both interventional and diagnostic radiology, and further research is needed to determine the value of these tests in the periprocedural setting.

Exploring microplastic impact on whole blood clotting dynamics utilizing thromboelastography

“…Samples were run in Additional TEG parameters collected included Time to Maximum Amplitude, Clotting Index, and G all of which can be found in Supplementary Tables 1−3. For a review of TEG parameter interpretation please reference Willis et al (17). Of note, the control groups did utilize Kaolin, as outlined in the manufacturer's protocol.…”

Precision Monitoring of Antithrombotic Therapy in Cardiovascular Disease

“…However, these indicators cannot adequately reflect interindividual differences in the status of the coagulation system. In recent years, new technologies such as thromboelastography have brought hope for individualized treatment; these methods can detect multiple dimensions, such as thrombin generation and platelet aggregation force, thus aiding in the assessment of individual coagulation function [6] and providing a basis for formulating precise anticoagulation treatment intensity. In addition, new tools such as genetic testing have shown promise [7] by enabling the identification of individual differences in patients' prothrombin activity, platelet adhesion capability, and other relevant functions.…”

Risk Factors for Hypocoagulability After Cardiac Surgery: A Retrospective Study

“…10 In contrast to conventional coagulation tests, which assess only single steps in the entire coagulation process, thromboelastography (TEG) can simultaneously assess the entire coagulation pathway, detecting insufficient levels of coagulation factors, reduced activity of fibrinogen or platelets, and hyperactive fibrinolysis (Figure 1). TEG is now widely used for monitoring coagulation function as well as guiding blood transfusion [11][12][13][14][15][16][17][18] and the use of anticoagulant or antiplatelet therapies. 19,20 Here we used TEG to assess pre-and postoperative coagulation function in patients at our medical center who underwent cardiac surgery involving cardiopulmonary bypass (CPB), and we explored potential associations between risk of hypocoagulability and clinicodemographic or perioperative characteristics in order to identify risk factors.…”

“…10 In contrast to conventional coagulation tests, which assess only single steps in the entire coagulation process, thromboelastography (TEG) can simultaneously assess the entire coagulation pathway, detecting insufficient levels of coagulation factors, reduced activity of fibrinogen or platelets, and hyperactive fibrinolysis (Figure 1). TEG is now widely used for monitoring coagulation function as well as guiding blood transfusion 11–18 and the use of anticoagulant or antiplatelet therapies. 19,20…”