Thrombosis Journal最新文献

{"title":"Anticoagulation-associated hemorrhage in atrial fibrillation as a marker of occult malignancy: a narrative review.","authors":"Arisha Masood, Zobia Aamir, Aaminah Khurram, Hira Tariq, Ayesha Shaukat, Azka Mujeeb, Aymar Akilimali","doi":"10.1186/s12959-026-00936-8","DOIUrl":"https://doi.org/10.1186/s12959-026-00936-8","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is the most common arrhythmia in adults and significantly increases the risk of stroke. Due to common threats like systemic inflammation and treatment-related cardiotoxicity, individuals with cancer have a noticeably increased chance of developing AF. Managing AF in this population presents dual challenges: reducing thromboembolic risk while minimizing bleeding complications. Traditionally, warfarin, a vitamin K antagonist, has been the most widely used anticoagulant. However, the emergence of direct oral anticoagulants (DOACs), which offer equal or superior efficacy compared to warfarin with fewer dietary and drug interactions, has shifted clinical practice. This narrative review explores the complex clinical relationship between AF, anticoagulation, and bleeding as a potential early indicator of occult cancer. An expanding body of evidence from extensive cohort studies and meta-analyses supports this association, showing a significantly increased risk of gastrointestinal, genitourinary, respiratory, and, to a lesser extent, intracranial bleeding in anticoagulated patients that may precede cancer diagnosis. Although bleeding is a recognized difficulty of oral anticoagulation, it may expose occult malignancy, resulting in timely detection of cancer and more favorable outcomes. Perhaps it is time to regard occult gastrointestinal bleeding for what it may be: an early warning sign of malignancy. The increased risk of both thromboembolism and bleeding in cancer patients poses a challenge in clinical practice. Though bleeding has increasingly been recognized as a potential harbinger of occult cancer, uniform guidelines for malignant lesion screening after a hemorrhagic episode remain to be established. It is essential to establish a solid, evidence-based therapeutic protocol to achieve the best possible treatment and results for patients.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"24 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Underlying thrombotic conditions in patients with splenic infarction: a 10-year retrospective analysis.","authors":"Ümit Karabulut, Berat Ebik, Ramazan Yolaçan, Yusuf Uğur, Fatma Yilmaz Öncül, Muhsin Kaya","doi":"10.1186/s12959-026-00934-w","DOIUrl":"https://doi.org/10.1186/s12959-026-00934-w","url":null,"abstract":"","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"24 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FIIX-based vitamin K antagonist monitoring: the promise of improved anticoagulation stability and clinical outcomes in mechanical heart valve patients.","authors":"Stephanie Carlin, John W Eikelboom, Emilie Belley-Cote","doi":"10.1186/s12959-026-00897-y","DOIUrl":"10.1186/s12959-026-00897-y","url":null,"abstract":"","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"24 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: factor II/X-guided warfarin monitoring for congenital factor VII deficiency after mechanical valve replacement.","authors":"Xiaokang Luo, Xinjian Yan","doi":"10.1186/s12959-026-00923-z","DOIUrl":"10.1186/s12959-026-00923-z","url":null,"abstract":"","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"24 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Underlying thrombotic conditions in patients with splenic infarction: a 10-year retrospective analysis.","authors":"Ümit Karabulut, Berat Ebik, Ramazan Yolaçan, Yusuf Uğur, Fatma Yilmaz Öncül, Muhsin Kaya","doi":"10.1186/s12959-026-00922-0","DOIUrl":"10.1186/s12959-026-00922-0","url":null,"abstract":"<p><strong>Background: </strong>Splenic infarction is a rare but clinically important condition that is usually associated with underlying hematological, cardiovascular, infectious, or malignant diseases. Due to its nonspecific clinical presentation, diagnosis may be delayed. This study aimed to evaluate the demographic characteristics, clinical findings, etiological factors, radiological features, treatment approaches, and outcomes of patients diagnosed with non-traumatic splenic infarction.</p><p><strong>Methods: </strong>This retrospective study included 67 adult patients diagnosed with splenic infarction by contrast-enhanced abdominal computed tomography (CT) at Dicle University Faculty of Medicine Hospital between January 2014 and December 2023. Demographic characteristics, presenting symptoms, laboratory parameters, radiological findings, etiological factors, treatment modalities, length of hospital stay, and in-hospital mortality were evaluated.</p><p><strong>Results: </strong>The mean age of the patients was 50.9 ± 16.3 years, and 64.2% were male. Abdominal pain was the most common presenting symptom and was present in all patients. Hematological disorders were the most common identifiable specific etiology (31.3%), while no identifiable cause was found in 23.9% of patients. Contrast-enhanced CT established the diagnosis in all patients, whereas ultrasonography detected infarction in only 29.9% of cases. JAK2 mutation analysis was positive in 4 of 16 tested patients with hematological disorders. Conservative management was sufficient in 89.6% of patients, while 10.4% required splenectomy because of splenic rupture, hemorrhagic infarction, or splenic abscess formation. In-hospital mortality occurred in four patients (6.0%).</p><p><strong>Conclusions: </strong>Splenic infarction is an uncommon clinical entity that should be considered in patients presenting with unexplained abdominal pain, particularly in the presence of hematological or systemic disorders associated with thrombotic risk. Contrast-enhanced CT remains the most reliable diagnostic modality, whereas ultrasonography has limited sensitivity. Although conservative management is effective in most patients, severe complications may necessitate surgical intervention. Early diagnosis and comprehensive etiological evaluation are essential for appropriate management and improved clinical outcomes.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"24 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balloon-assisted radial release for retrieval of a surgically suture-fixed inferior vena cava filter: a case report.","authors":"Peng Gao, HuanLiang Liu, Jindi Wei, Xuanfeng Zhu, Xiquan Zhang","doi":"10.1186/s12959-026-00913-1","DOIUrl":"10.1186/s12959-026-00913-1","url":null,"abstract":"<p><strong>Background: </strong>The retrieval of an inferior vena cava (IVC) filter is essential for preventing complications related to the filter. Surgically induced suture fixation is an extremely rare cause of filter entrapment and presents unique technical challenges. This case describes a balloon-assisted radial release within the filter frame followed by snare retrieval to successfully address this condition.</p><p><strong>Case presentation: </strong>We report a rare case of successful retrieval of a surgically suture-fixed inferior vena cava filter via femoral venous access using a balloon-assisted radial release technique combined with snare retrieval, which has not been previously reported. An endovascular strategy of \"release first, then retrieval\" was adopted. Sequential balloon dilations were performed to achieve controlled radial expansion and mechanical release at the fixation site. Following controlled strut fracture and resolution of the external constraint, the filter was completely retrieved using a snare technique under large-sheath protection.</p><p><strong>Conclusion: </strong>The balloon-assisted radial release technique may provide a minimally invasive solution for the retrieval of inferior vena cava filters fixed by surgical sutures.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"24 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NET-mediated immunothrombosis in ischemic stroke: pathobiology, biomarkers, and therapeutic targeting.","authors":"Nicholas Aderinto, Thomas Oyediran, Mehari Wale Alem, Aderinola Halimat Abioye, Meron Yitna Teshome, Andrew Jacobs Bilson, Sharon Anjolaoluwa Oyelayo, Pearl Ohenewaa Tenkorang","doi":"10.1186/s12959-026-00917-x","DOIUrl":"10.1186/s12959-026-00917-x","url":null,"abstract":"<p><p>Ischemic stroke is increasingly understood not as a purely thromboembolic event but as a thromboinflammatory disease in which innate immune and hemostatic pathways interact. Neutrophil extracellular traps (NETs) have emerged as potentially important mediators and biomarkers within this broader immunothrombotic network. Experimental studies provide mechanistic evidence that NETs can stabilize thrombi, impair fibrinolysis, obstruct the microcirculation, and promote neurovascular injury, whereas human studies predominantly demonstrate associations between NET burden, reperfusion difficulty, and adverse clinical outcomes. This review critically synthesizes mechanistic, translational, observational, and emerging interventional evidence linking NETs to ischemic stroke. We distinguish established experimental mechanisms from human associations, place NETs within reciprocal interactions involving platelets, endothelial cells, monocytes/macrophages, complement, coagulation, and inflammatory mediators, and examine current controversies and barriers to therapeutic translation. We further consider DNase-mediated NET degradation, PAD4 inhibition, biomarker-guided patient selection, high-resolution multiomic and spatial technologies, and imaging-based thrombus characterization. This evidence-calibrated framework identifies where NET biology is most strongly supported and where causal and clinical uncertainty remains.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"24 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of acid selection on thrombelastometric test results - an in-vitro cohort study.","authors":"Gerrit U Herpertz, Johannes Altmann, Bernhard H Rauch, Christian F Weber, Simon T Schäfer, Greta Bischof-Westermann","doi":"10.1186/s12959-026-00912-2","DOIUrl":"https://doi.org/10.1186/s12959-026-00912-2","url":null,"abstract":"<p><strong>Background: </strong>Acidosis is common in critically ill patients and is associated with coagulopathy. The impact of different acids on coagulation remains poorly understood. Hydrochloric acid has often been used without critical evaluation. We aimed to investigate the influence of different acids and their concentrations on rotational thromboelastometry (ROTEM).</p><p><strong>Methods: </strong>In this observational study ten, blood samples were treated with hydrochloric acid (HCl), lactic acid (C₃H₆O₃), phosphoric acid (H₃PO₄), or dihydrogen phosphate (H₂PO₄⁻) to achieve defined pH levels (7.2-6.9). Respiratory acidosis was simulated by incubation in a 20% CO₂ atmosphere. Five additional samples were exposed to varying acid concentrations. Samples were analyzed using the ROTEM EXTEM assay. Clotting time (CT), clot formation time (CFT), α-angle, maximum clot firmness (MCF), and maximum lysis (ML) were assessed.</p><p><strong>Results: </strong>All acids exhibited concentration-dependent effects on EXTEM parameters. HCl caused significant reductions in MCF and prolonged CFT, indicating impaired clot firmness and propagation. C₃H₆O₃ induced moderate changes, with elevated fibrinolysis at intermediate concentrations. H₃PO₄ reduced MCF and increased ML, while H₂PO₄⁻ primarily delayed clotting initiation and markedly inhibited fibrinolysis. CO₂-induced acidosis (pH ≈ 7.1) led to reduced fibrinolytic activity without affecting CT or MCF. Across acid types, increasing acidity consistently impaired clotting dynamics.</p><p><strong>Conclusion: </strong>The type of acid inducing acidosis was associated with distinct alterations in ROTEM parameters in vitro. The choice of acid should be carefully considered in experimental models and taken into account when interpreting data. Whether such effects occur in vivo remains uncertain.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"24 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe immune thrombocytopenia induced by vancomycin in a critically ill patient: a case report and literature review.","authors":"Niloofar Khoshnam Rad, Fatemeh Ghasemi, Shahram Firouzbakhsh, Bita Rashidinejad","doi":"10.1186/s12959-026-00911-3","DOIUrl":"https://doi.org/10.1186/s12959-026-00911-3","url":null,"abstract":"<p><strong>Background: </strong>Vancomycin-induced immune thrombocytopenia (VIIT) is a rare but potentially life-threatening adverse drug reaction characterized by profound platelet destruction. Diagnosis is challenging in critically ill patients, and optimal management beyond drug cessation remains poorly defined. A 54-year-old female admitted to the ICU for severe community-acquired pneumonia developed profound, refractory thrombocytopenia 12 days after the initiation of vancomycin. Blood, sputum, and pleural fluid cultures were negative. Vancomycin was continued due to the severity of the pneumonia, a fluctuating clinical course with recurrent fevers and progressive infiltrates, a complicated parapneumonic effusion requiring drainage and surgical consultation, and infectious disease service recommendations. The patient presented with gross hematuria and a rapid decline in platelet count to 6,000/µL. Following the exclusion of alternative etiologies-including sepsis-associated coagulopathy and heparin-induced thrombocytopenia (HIT)-vancomycin was discontinued. The patient required intravenous immunoglobulin (IVIG) and corticosteroids in addition to drug cessation to achieve platelet recovery.</p><p><strong>Conclusion: </strong>This case underscores the critical importance of early recognition of VIIT. Our literature review reveals that while discontinuation of the offending agent is the cornerstone of therapy, severe cases (platelets < 20,000/µL) often require adjunctive immunomodulatory treatment. VIIT should remain a primary differential diagnosis in patients presenting with unexplained thrombocytopenia during vancomycin therapy.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"24 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating pulmonary embolism response teams: perspectives and outcomes from a European and German survey analysis.","authors":"Lukas Hobohm, Karsten Stannek, Karsten Keller, Ioannis T Farmakis, Tobias Tichelbaecker, Philipp Lurz, Christian Perings, Stavros Konstantinides, Ingo Ahrens","doi":"10.1186/s12959-026-00872-7","DOIUrl":"10.1186/s12959-026-00872-7","url":null,"abstract":"<p><p>In recent years, establishing multidisciplinary pulmonary embolism response teams (PERTs/EXPERT-PE) has become more prevalent. A survey was conducted to assess the availability and structure of PERTs in German and European hospitals. A survey was circulated among German hospital centers with cardiovascular expertise to obtain data on their current PE treatment approaches, the existence and features of PERTs, their activation methods, and their structural organization. Additionally, data regarding PE treatment priority relative to acute coronary syndrome and the availability of outpatient PE follow-up programs was gathered. Results were compared with those of European PE reference centers. Overall, 65 hospitals participated at this German survey with most PERTs available at university hospitals (63%), especially in West (63%) and Southern (62%). Although 61.5% of the German centers handle over 40 PE cases annually, only 52.3% of those hospitals already implemented a PERT, which is low in comparison to a European Survey among PE reference centers (80.8%). In 86% cases, PERT is led by Cardiology, followed by Angiology (6.9%), Pulmonology (4.6%), and Critical Care Medicine (2.3%). Regarding advanced treatment the majority of hospitals performed catheter-directed thrombolysis (72.2%) and catheter-based thrombectomy/aspiration (74.1%). A follow-up program for patients with PE is considerable higher in European reference centers opposed to German hospitals. This survey demonstrated that among large German cardiovascular centers PERTs are markedly less often present compared to European PE reference centers. Additionally, in German centers, PE follow-up programs are not widely implemented. This emphasizes the pressing need for awareness campaigns for acute and chronic PE.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"24 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}