Journal of Thrombosis and Thrombolysis最新文献

{"title":"Thrombus composition in ischaemic stroke: histological and radiological evaluation, and implications for acute clinical management.","authors":"Esmee Dohle, Abhishekh H Ashok, Shiv Bhakta, Isuru Induruwa, Nicholas R Evans","doi":"10.1007/s11239-025-03074-6","DOIUrl":"https://doi.org/10.1007/s11239-025-03074-6","url":null,"abstract":"<p><p>Ischaemic stroke is one of the key causes of morbidity and mortality worldwide. Although rapid reperfusion through thrombolysis or mechanical thrombectomy is the cornerstone of acute management, the efficacy of these interventions is influenced by the underlying composition of the occluding thrombus, which varies widely. Histological examination of retrieved thrombi allows the determination of thrombus composition and may inform aetiology and secondary prevention strategies. Additionally, radiological features may provide valuable pre-treatment insights into thrombus composition to help predict treatment success. This narrative review discusses histological and radiological indicators of thrombus composition, and how this may predict success of thrombolysis and thrombectomy. Furthermore, it discusses how these insights can be applied in the diagnostic work-up of embolic stroke of undetermined source (ESUS), and the potential utility of emerging biomarkers relating to thrombus formation, in order to optimise secondary prevention strategies.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of thrombocytopenia and anticoagulant therapy in patients with hematological malignancy on chemotherapy: a binational prospective study (TAT study).","authors":"Elie Jalaber, Corentin Orvain, Vasiliki Papadopoulou, Alexis Genthon, Valentin Daguerre, Sabrina Barrière, Alice Teste, Emmanuelle Tavernier, Elisabeth Daguenet, Emilie Chalayer","doi":"10.1007/s11239-025-03085-3","DOIUrl":"https://doi.org/10.1007/s11239-025-03085-3","url":null,"abstract":"<p><p>Anticoagulant use in patients with hematological malignancies treated on intensive chemotherapy represents a management challenge because of concomitant thrombocytopenia. This prospective multi-center cohort included 100 patients with hematological malignancies on anticoagulation. The aims of the study were to assess the incidence of WHO grade ≥ 2 bleeding, describe physician management strategies during thrombocytopenia (platelet count < 50 × 10⁹//L), and examine short-term outcomes and risk factors for bleeding and thrombosis. Median patients age was 60 years and median duration of severe thrombocytopenia was 16 days. The 30-day cumulative incidence of WHO grade ≥ 2 bleeding was 29.3% (95% CI 19.4-39.8), grade 4 bleeding was 7.2% (95% CI 2.8-14.2) and incidence of thrombus recurrence/progression was 6.2% (95% CI 2.2-13.3). No deaths occurred. The majority of patients received full-dose anticoagulation with a high platelet transfusion threshold. Half of the bleeding episodes grade ≥ 2 occurred with platelets counts between 20 and 50 × 10⁹/L. Longer period of full-dose anticoagulation during thrombocytopenia was associated with increased bleeding risk (16 days [IQR: 6-29] for participants who presented ≥ grade 2 bleeding versus 7 days for those who did not [IQR: 2-14], p < 0.001). So was a HAS-BLED score ≥ 3 (HR = 9 [4.1-20], p < 0.001). Multiple myeloma diagnosis was associated with lower bleeding risk versus other hematological malignancies (HR = 0.2 [0.0-0.9], p = 0.05). Our study underscores the complex trade-off between preventing thrombotic events' progression or recurrence and avoidance of bleeding. We highlight specific clinical scenarios and consider different risk factors. Future randomized controlled trials are required for these complex situations to achieve a rationalization of their management.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recanalization is more important than procedure time on outcome of thrombectomy in acute vertebrobasilar artery occlusion.","authors":"Wenya Lan, Danyu Feng, Kefan Qiu, Mingyang Du, Feng Qiu, Lulu Xiao, Wen Sun, Zhongming Qiu, Hongfei Sang, Lingfei Li, Kefeng Luan, Xinfeng Liu, Hui Cao","doi":"10.1007/s11239-025-03082-6","DOIUrl":"https://doi.org/10.1007/s11239-025-03082-6","url":null,"abstract":"<p><p>Longer procedure time (PT) predicts worse prognosis after endovascular treatment (EVT) in acute vertebrobasilar artery occlusion (VBAO), but it remains unknown whether it is worth pursuing recanalization when the PT is obviously extended. Patients with acute VBAO who received EVT were retrospectively enrolled from 21 stroke centers in China from December 2015 to December 2018. Multivariable logistic analysis was performed to analyze the associations of PT with favorable outcome (defined as modified Rankin Scale score of 0 to 3) and mortality at 90 days. A total of 541 patients with median age of 64 years (IQR, 55-73) were included. The median baseline National institutes of Health stroke scale score was 23 (IQR, 14-28) and PT was 110 min (IQR, 74-156). The rate of favorable outcome was 36.5% in patients with PT 111-155 min (adjusted OR 0.51 [95% CI 0.28-0.92]) and 33.3% in patients with PT > 155 min (adjusted OR 0.52 [95% CI 0.29-0.93]) compared with 42.9% in patients with PT ≤ 75 min. Compared with the PT ≤ 75 min, PT of 111-155 min (adjusted OR 1.96 [95% CI 1.11-3.46]) and PT > 155 min (adjusted OR 2.10 [95% CI 1.21-3.66]) were associated with increased risks of mortality. Recanalization within four PT intervals were consistently associated with better outcomes compared with failure of recanalization (all P < 0.05). For acute VBAO patients treated with EVT, recanalization regardless of PT was associated with improved prognosis than failure of recanalization, supporting the continued pursuit of recanalization despite the PT being obviously extended. The findings need validation in randomized controlled trials.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous thrombolysis with tenecteplase versus alteplase in acute ischemic stroke tandem occlusions: a systematic review and meta-analysis of current available literature.","authors":"Ocílio Ribeiro Gonçalves, Márcio Yuri Ferreira, Gabriel de Almeida Monteiro, Victor Gonçalves Soares, Luiza G Schmitt, Sávio Batista, Luís O S Nogueira, Christian Ken Fukunaga, João Victor Araújo de Oliveira, João de Deus Costa Alves, Kelson James Almeida","doi":"10.1007/s11239-025-03084-4","DOIUrl":"https://doi.org/10.1007/s11239-025-03084-4","url":null,"abstract":"<p><p>Tandem occlusions, characterized by the simultaneous occurrence of both extracranial and ipsilateral intracranial arterial occlusions, represents a challenging subset of large vessel occlusion (LVO) strokes. Currently, the treatment choice for tandem infarcts involves intravenous thrombolysis (IVT) followed by endovascular thrombectomy (EVT). In current literature, direct head-to-head comparisons between Alteplase and Tenecteplase for IVT in patients with tandem occlusions remain limited. The goal of this systematic review and meta-analysis is to synthesize the currently available data comparing the efficacy and safety profiles of alteplase and tenecteplase specifically in patients with tandem occlusions. We systematically searched PubMed, Embase and Cochrane from inception to June 2024 for studies enrolling patients with tandem lesions in acute ischemic stroke (AIS) treated with IVT involving Tenecteplase or Alteplase. The primary outcomes of interest were (1) modified Rankin Scale (mRS) 0-1, (2) modified Rankin Scale (mRS) 0-2, (3) successful recanalization (TICI 2b-3), (4) symptomatic intracranial hemorrhage (sICH) and (5) overall mortality. We compared the results using Risk Ratio (RR) with 95% Confidence Intervals (CI). A random effects model was applied for all outcomes. The Mantel-Haenszel method was used to pool results from individual studies. We also used I² statistics and Cochran Q test to verify heterogeneity. Three studies published between 2023 and 2024 were included, two randomized controlled trials (RCTs) and one observational study, comprising 917 patients. Tenecteplase was administered for 230 (25,1%) patients. The age ranged from 57 to 82 years, the baseline NIHSS ranged from 10 to 24 points and there were 314 (34.2%) female patients in total. There was no statistically significant difference between groups for the outcomes of mRS 0-1 (RR 0.80; 95% CI 0.35 to 1.83; p = 0.597; I² = 86%), mRS 0-2 (RR 1.04; 95% CI 0.88 to 1.23; p = 0.630; I² = 0%), TICI 2b-3 (RR 1.00; 95% CI 0.93 to 1.09; p = 0.909; I² = 0%), sICH (RR 1.09; 95% CI 0.64 to 1.84; p = 0.756; I² = 0%), and overall mortality (RR 0.68; 95% CI 0.45 to 1.05; p = 0.081; I² = 17%). This meta-analysis found that tenecteplase achieved similar outcomes to alteplase in improving functional outcomes and recanalization rates. Additionally, there was no significant difference between tenecteplase and alteplase in terms of rates of sICH and mortality. Further large-scale randomized studies are urgently needed to provide a definitive conclusion on the comparative efficacy and safety of tenecteplase versus alteplase in tandem occlusions.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of arterial and venous thromboembolism in cancer patients- insights from more than 5,000,000 patients.","authors":"Hai-Wei Deng, Jie Li, Yuan-Sheng Zhai, Wei-Yi Mei, Xiao-Xiong Lin, Qing Xu, Qian Zheng, Jin-Sheng Chen, Zhi-Bin Huang, Xing Wu, Yun-Jiu Cheng","doi":"10.1007/s11239-025-03083-5","DOIUrl":"https://doi.org/10.1007/s11239-025-03083-5","url":null,"abstract":"<p><p>The reported incidence of arterial thromboembolism (ATE) and venous thromboembolism (VTE) after cancer varies. A meta-analysis was performed to define the incidence of thromboembolism (TE) in cancer patients. Articles were searched in PubMed and Embase from inception to November 1, 2023. Studies reporting the incidence data or data from which incidence could be estimated among patients with cancer and the explicit follow-up duration were included. Seventy-four studies involving 5,059,134 cancer patients were identified. The incidence rate per 1000 person-years was 11.60 (95% CI 7.62-15.58) for ATE, 6.11 (95% CI 3.70-8.53) for myocardial infarction, 9.07 (95% CI 7.48-10.66) for ischemic stroke, 2.11 (95% CI 0.89-3.31) for another ATE, 26.32 (95% CI 24.46-28.18) for VTE, 12.69 (95% CI 11.51-13.87) for deep vein thrombosis, 5.94 (95% CI 5.29-6.59) for pulmonary embolism, and 13.18 (95% CI 9.93-16.42) for another VTE. In addition, the highest incidence of ATE was observed in patients with gastrointestinal cancer, while patients with pancreatic cancer had the highest incidence of VTE. The risk of ATE and VTE increased at the initial stage of cancer, and then declined and became non-significant. This meta-analysis provided overall estimates of ATE and VTE incidence in cancer patients, adding an important insight into the trajectory of the development of TE in cancer patients, which could help the early detection of TE in cancer patients in the future.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune checkpoint inhibitors and myocardial infarction.","authors":"Vencel Juhasz, Giselle Alexandra Suero-Abreu, Tomas G Neilan","doi":"10.1007/s11239-025-03081-7","DOIUrl":"https://doi.org/10.1007/s11239-025-03081-7","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy since their first approval in 2011. By unleashing the adaptive immune system, non-cardiac and cardiac immune-related adverse events (irAEs) are common and often pose a challenge to multidisciplinary teams treating cancer patients. A significant body of literature reports accelerated atherosclerosis - a key precursor of acute vascular events (AVEs) - with currently approved ICIs (CTLA-4, PD-1, LAG-3, and PD-L1 inhibitors), and some preclinical research also suggests increased thrombogenicity. A large meta-analysis has reported an increased incidence of AVEs, including myocardial infarction (MI) and stroke with ICIs. In addition, dyslipidemia secondary to ICI use may lead to an increase in cardiovascular (CV) events in long-term cancer survivors. Currently, there are no specific guidelines for the treatment of MI or CV risk in cancer patients with ICIs. Overall survival (≥ 6 months), thrombogenic, and bleeding risk are key determinants in choosing the appropriate acute approach and antithrombotic therapy, while other principles of MI management do not differ between cancer and non-cancer patients. Future avenues of research include lipid-lowering therapies, including PCSK9 inhibitors and statins, which may offer dual beneficial effects by improving anti-cancer efficacy and reducing CV risk. In addition, newer immune checkpoint targets may provide atheroprotection while being effective against certain cancers (e.g., CD47). Given the tremendous potential of ICIs, intensive research is warranted to reduce CV risk and the incidence of AVE, including MI, in active cancer patients and survivors.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tissue factor pathway inhibitor levels and atherothrombotic events in patients with chronic kidney disease or diabetes.","authors":"Rowena Brook, Mani Suleiman, Joseph Rigano, Brandon Lui, Harshal Nandurkar, Prahlad Ho, Hui Yin Lim","doi":"10.1007/s11239-025-03077-3","DOIUrl":"https://doi.org/10.1007/s11239-025-03077-3","url":null,"abstract":"<p><p>Increased tissue factor pathway inhibitor (TFPI) has been associated with cardiovascular disease (CVD). We aim to evaluate the predictive capability of TFPI for atherothrombotic events (ATE) in patients with chronic kidney disease (CKD) and diabetes. A prospective observational study was performed at Northern Health, Australia. Patients with CKD (estimated glomerular filtration ratio (eGFR) < 30 ml/min/1.73m²) and/or diabetes were recruited. Baseline total TFPI was measured and the median follow-up was 3.35 years. All patients with egfr < 30 ml/min/1.73m² were analysed as CKD cohort while the diabetes cohort analysis excluded those with egfr < 30 ml/min/1.73m². The primary outcome was ATE (myocardial infarction, stroke/transient ischaemic attack, critical limb ischaemia or sudden cardiac death). 220 patients were recruited, median age 63.5 years (IQR 51.0, 72.5) and 59.1% males (n = 130). No differences were seen in TFPI levels between the CKD (n = 77) and diabetes (n = 143) cohorts (35.4 vs. 36.4 ng/mL, p = 0.44). TFPI did not correlate with creatinine or HbA1c levels. 46 episodes of ATE were captured (6.69/100-person years (100PY)), with a higher rate in the CKD compared to the diabetes cohort (16.03/100PY vs. 2.53/100PY). In the CKD cohort, those who experienced ATE had higher TFPI with an optimal calculated cut-off (61.36ng/mL) associated with a subhazard ratio of 3.23 (95%CI 1.59-6.57). In the diabetes cohort however, TFPI was not significantly higher in those who experience ATE (40.1 vs. 34.4ng/mL, p = 0.35). We found elevated TFPI may predict prospective ATE, particularly in patients with CKD. While further validation studies are required, these findings highlight that coagulation changes may differ between high-risk CVD populations.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of venous thromboembolic events in hospitalized patients with COVID-19.","authors":"Giovanni Scimeca, Darsiya Krishnathasan, Sina Rashedi, Zhou Lan, Alyssa Sato, Nada Hamade, Antoine Bejjani, Candrika D Khairani, Julia Davies, Nicole Porio, Ali A Assi, Andre Armero, Anthony Tristani, Marcos D Ortiz-Rios, Victor Nauffal, Zaid Almarzooq, Eric Wei, Valeria Zuluaga-Sánchez, Mehrdad Zarghami, Aditya Achanta, Sirus J Jesudasen, Bruce Tiu, Geno J Merli, Orly Leiva, John Fanikos, Aditya Sharma, Samantha Rizzo, Mariana B Pfeferman, Ruth B Morrison, Alec Vishnevsky, Judith Hsia, Mark R Nehler, James Welker, Marc P Bonaca, Brett Carroll, Samuel Z Goldhaber, Umberto Campia, Behnood Bikdeli, Gregory Piazza","doi":"10.1007/s11239-025-03078-2","DOIUrl":"https://doi.org/10.1007/s11239-025-03078-2","url":null,"abstract":"<p><p>COVID-19 is associated with an increased risk of venous thromboembolism (VTE) in hospitalized patients. Although prior studies have attempted to identify predictors of VTE, restricted sample size and use of administrative claims data have limited such analyses. We utilized data from hospitalized patients in the CORONA-VTE Network, a United States multicenter registry of adult patients with PCR-confirmed COVID-19 (N = 3,844). The primary outcome was time-to-first event for a composite of adjudicated pulmonary embolism or deep vein thrombosis during 90-day follow-up. The candidate variables were selected by a priori clinical consensus. We conducted cause-specific Cox regression analysis adjusted for the selected variables for each imputed dataset and pooled the estimated HRs for reporting (p < 0.05 for significance). VTE occurred in 206 patients, with a cumulative incidence of 5.3% at 90 days. The covariates associated with increased risk of VTE were history of VTE (HR: 1.71; 95% CI: 1.11-2.63), corticosteroid therapy (HR: 1.76; 95% CI: 1.32-2.33) and known thrombophilia (HR: 3.56; 95% CI: 1.54-8.21) while therapeutic anticoagulation at baseline (HR: 0.42; 95% CI: 0.26-0.69), antecedent use of statins (HR: 0.67; 95% CI: 0.50-0.90), and prophylactic anticoagulation during hospitalization (HR: 0.52; 95% CI: 0.38-0.71) were associated with reduced risk of VTE. While prior VTE, corticosteroid therapy, and known thrombophilia were associated with an increased risk of VTE, prescriptions of prophylactic and therapeutic anticoagulation, and statins were associated with a decreased risk. Once externally validated, these findings may inform risk assessment in hospitalized patients with COVID-19.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significant attenuation of fully automated thrombin generation in newly diagnosed multiple myeloma patients after induction therapy.","authors":"Diego Velasco-Rodríguez, Inés Martínez-Alfonzo, Alberto Eterio Velasco-Valdazo, Amalia Domingo-González, Nuria Revilla, Ignacio Mahíllo-Fernández, Elham Askari, María Jesús Blanchard, Rosa Vidal Laso, Laura Fernández-Cuezva, Nerea Castro-Quismondo, Elena Prieto, Juana Serrano-López, Belén Rosado, Daniel Naya, Sara Martín-Herrero, Marina Menéndez, María Yuste, Irene Sánchez-Prieto, Ana Jiménez-Martín, María Ángeles Bueno, Reyes de la Plaza, Joaquín Martínez-López, José Manuel Calvo-Villas, Javier López-Jiménez, Pilar Llamas-Sillero","doi":"10.1007/s11239-025-03079-1","DOIUrl":"https://doi.org/10.1007/s11239-025-03079-1","url":null,"abstract":"<p><p>Nearly 10% of newly diagnosed multiple myeloma (NDMM) patients develop a venous thromboembolism (VTE) episode during their disease course, despite current thromboprophylaxis strategies. Changes in hypercoagulability in these patients after treatment have been analyzed using the thrombin generation (TG) assay, the results being discrepant, probably due to the use of semi-automated techniques. This study aims to assess changes in TG measured by a fully automated analyzer. This prospective and multicentric study included NDMM patients from 8 centers (December 2018-September 2023). Fully automated TG was measured at baseline and after 1 and 4 cycles of treatment with ST Genesia® analyzer. Among 100 NDMM patients, a significant decrease was observed in velocity index (after 1 cycle) and peak height (after 4 cycles) and alongside increased sensitivity to thrombomodulin (after 4 cycles), indicating a reduction in hypercoagulability post-treatment. No differences in TG were observed according to the depth of response after 4 cycles. Patients on daratumumab-containing regimens experienced a transient increase in TG after cycle 1, whereas those on proteasome inhibitors (PI)-containing regimens showed a significant reduction in peak height and velocity index after 4 cycles. The development of a VTE event was associated with increased mortality, but there was no association between VTE development and TG results at baseline. Hypercoagulability decreases with anti-myeloma treatment, especially in those receiving PI-containing regimens. These changes in TG are not related to the depth of response to treatment.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the complexities of catheter-related thrombosis: risk factors, preventive strategies, and management.","authors":"Hannah L King, Thalia Padilla-Lazos, Akshit Chitkara, Virginia Tan, Genevieve B Benedetti, Aya Agha, Kylee L Martens, Joseph J Shatzel","doi":"10.1007/s11239-025-03073-7","DOIUrl":"https://doi.org/10.1007/s11239-025-03073-7","url":null,"abstract":"<p><p>Catheter-related deep venous thrombosis (CR-DVT) is a common complication of central venous catheters, however optimal prophylactic and treatment strategies have yet to be fully defined. While the use of anticoagulation for CR-DVT prophylaxis is not routinely recommended, current available data offer heterogeneous results due to small sample size, non-uniform study design, and varying comorbid conditions. Available guidelines for the treatment of CR-DVT generally recommend a limited duration of anticoagulation after catheter removal. If ongoing use is required and the device remains functional, guidelines support anticoagulation throughout the time the catheter remains in place. It is worth acknowledging that data guiding these recommendations is largely derived from observational studies of upper extremity CR-DVT, along with randomized trials of anticoagulation in patients with lower extremity DVT. Therefore, large, randomized controlled trials are desperately needed to define optimal management, especially in patients who are at high risk for bleeding. This review explores the epidemiology and risk factors of CR-DVT, diagnostic, prophylactic and treatment strategies, guideline recommendations, and future advances in the field, including the introduction of novel anticoagulants. With current available evidence, we also conclude with an individualized approach to preventing and managing CR-DVT to assist clinicians who are faced with this common clinical scenario.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}