Thrombosis research最新文献

{"title":"Inferior vena cava filter-related thrombosis: Mechanisms, clinical features, prevention, diagnosis, and risk-stratified management.","authors":"Weilun Xu, Wentao Yu, Yuchong Zhu, Long Wang, Xin Li, Ting Zheng, Zuolei Shi, Rongwei Xu, Minghai Wang, Tao Zhang","doi":"10.1016/j.thromres.2026.109894","DOIUrl":"https://doi.org/10.1016/j.thromres.2026.109894","url":null,"abstract":"<p><p>Inferior vena cava (IVC) filters can provide mechanical protection from pulmonary embolism in selected patients who cannot receive anticoagulation, but filter-related thrombosis is an important complication. A uniform definition is lacking. Thrombus in the filter region may represent emboli captured by the filter, extension of pre-existing deep vein thrombosis, or local thrombus formation around the device. Filter-induced flow disturbance and vessel-wall responses may contribute to local thrombosis, although direct mechanistic evidence in humans remains limited. Reported occurrence varies substantially because study populations, imaging schedules, and outcome definitions differ. Clinically detected caval thrombosis or thrombotic occlusion is uncommon in large databases and prospective cohorts. Planned imaging before retrieval, however, often detects small intrafilter thrombi, most of which are asymptomatic. Accordingly, the clinical importance of an imaging-detected thrombus depends on whether it is accompanied by meaningful caval obstruction or symptoms. Prevention should continue throughout the filter life cycle. Filters should be used only for a time-limited, evidence-based indication. Anticoagulation should be resumed when a separate indication persists and bleeding risk permits, and retrieval should be assessed once filter-mediated pulmonary embolism protection is no longer required. Structured follow-up can help prevent loss to care. Management of established thrombosis should be guided by symptoms, impaired caval outflow, thrombus progression and chronicity, bleeding risk, and the need for filter retrieval. Anticoagulation remains foundational when indicated for active venous thromboembolism. Catheter-directed thrombolysis, mechanical thrombectomy, or combined treatment may be considered for selected symptomatic, progressive, or obstructive cases, but most supporting studies are nonrandomized. Future studies require standardized minimum reporting and patient-centered outcomes.</p>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"266 ","pages":"109894"},"PeriodicalIF":3.4,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246238","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":"Real-world data of extended half-life factor VIII prophylaxis in patients with hemophilia A: A multicenter retrospective cohort study.","authors":"Sinan Demircioğlu, Abdullah Karakuş, Vehbi Demircan, Özge Soyer Kösemehmetoğlu, Beytullah Altınkaynak, Tekin Güney, Nuray Gül Açar, Vahap Okan, Özlem Beyler, Cengiz Demir, Aydan Akdeniz, Tuğba Ceren Yılmaz, Ünal Ataş, Ramazan İpek, Ali Doğan, Ṣerife Emre Ünsal, Muzaffer Keklik, Gülsüm Akgün Çağlıyan, Rafiye Çiftçiler, Mehmet Can Uğur, Aslı Kum, Lütfiye Seçil Deniz Balyen, Kübra Yel Uygun, İbrahim Halil Açar, Atakan Tekinalp, Fevzi Altuntaş","doi":"10.1016/j.thromres.2026.109871","DOIUrl":"https://doi.org/10.1016/j.thromres.2026.109871","url":null,"abstract":"<p><strong>Background: </strong>Extended half-life factor VIII (EHL-FVIII) products were developed to reduce infusion frequency and improve bleeding control in hemophilia A, but real-world data on switching from standard half-life FVIII (SHL-FVIII) prophylaxis remain limited. This study aimed to evaluate the effectiveness and treatment characteristics of EHL-FVIII prophylaxis in patients with hemophilia A in a real-world multicenter cohort.</p><p><strong>Methods: </strong>This multicenter retrospective cohort study included adult patients with hemophilia A from 16 hospitals in Türkiye who had received at least one year of SHL-FVIII prophylaxis followed by at least one year of EHL-FVIII prophylaxis. Each patient served as his own historical control. Bleeding outcomes during EHL-FVIII prophylaxis were compared with those recorded during the final 12 months of preceding SHL-FVIII prophylaxis. The primary outcome was the change in annualized bleeding rate (ABR), with annualized joint bleeding rate (AJBR) evaluated as an additional clinical outcome.</p><p><strong>Results: </strong>A total of 192 patients were included, with a median age of 28 years; 83.9% had severe hemophilia A. Following the switch from SHL-FVIII to EHL-FVIII prophylaxis, median ABR decreased from 3 (range, 0-22) to 1 (range, 0-14) (p < 0.001), while median AJBR decreased from 2 (range, 0-22) to 1 (range, 0-14) (p < 0.001). During EHL-FVIII prophylaxis, the median infusion frequency was 2 infusions per week, and 62% of patients received twice-weekly prophylaxis.</p><p><strong>Conclusions: </strong>In this real-world multicenter cohort, switching from SHL-FVIII to EHL-FVIII prophylaxis improved bleeding outcomes in hemophilia A. EHL-FVIII products reduced infusion burden while maintaining effective bleed prevention, supporting their role in hemophilia management.</p>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"266 ","pages":"109871"},"PeriodicalIF":3.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228694","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":"Apixaban for thromboprophylaxis in paediatric cardiology patients: Real-world data from a single institution.","authors":"Alessandra Bosch, Florian Berger, Hitendu Dave, Manuela Albisetti","doi":"10.1016/j.thromres.2026.109893","DOIUrl":"https://doi.org/10.1016/j.thromres.2026.109893","url":null,"abstract":"<p><strong>Background: </strong>Thrombosis is a major complication in children with congenital or acquired heart disease, contributing to significant morbidity and mortality. Direct oral anticoagulants (DOACs), including apixaban, are increasingly used for thromboprophylaxis in this population yet real-world paediatric data remain limited.</p><p><strong>Objectives: </strong>To evaluate the safety and effectiveness of apixaban as thromboprophylaxis in paediatric cardiac patients receiving commercially available adult tablet formulations outside a clinical trial setting.</p><p><strong>Patients/methods: </strong>This retrospective cohort study included patients aged ≤18 years with congenital or acquired heart disease who received apixaban at the University Children's Hospital Zurich from October 2022 to June 2025. Dosing was approximated to the SAXOPHONE trial using commercially available tablets that were split or crushed, without therapeutic laboratory monitoring. Outcomes included incident thrombosis (primary), major bleeding, clinically relevant non-major bleeding (CRNMB), and all-cause mortality.</p><p><strong>Results: </strong>Sixty-seven patients were included with a median age of 4.6 years (IQR 3.3-9.8) and median apixaban exposure of 210 days (IQR 83-461), totalling 18,799 patient-days (51.5 patient-years). Single ventricle physiology was the most common underlying diagnosis (40/67, 60%) and Fontan circulation the most frequent indication (34/67, 51%). Two thrombotic events occurred (incidence rate 3.9 per 100 patient-years), both in the context of additional thrombotic risk factors. No major bleeding or CRNMB events were recorded.</p><p><strong>Conclusions: </strong>Apixaban appeared safe and effective as thromboprophylaxis in this paediatric cardiology cohort, with no major or CRNMB and a low rate of thrombotic events. These findings add to the growing body of real-world evidence supporting DOAC use in children with cardiac disease.</p>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"266 ","pages":"109893"},"PeriodicalIF":3.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246210","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":"Predictive performance of bleeding risk scores for extended anticoagulation in pulmonary embolism: Insights from the CURES-2 registry.","authors":"Rui Liang, Yuzhi Tao, Chunling Dong, Hong Chen, Yiwei Shi, Xiaomao Xu, Maoyun Wang, Ling Zhu, Juhong Shi, Xiaomeng Zhang, Ying Tang, Wenxuan He, Jiarui Li, Ran Miao, Peiran Yang, Jun Wan, Dingyi Wang, Yu Zhang, Jixiang Liu, Shuai Zhang, Zhu Zhang, Qiang Huang, Wanmu Xie, Yunxia Zhang, Huangying Tan, Zhenguo Zhai","doi":"10.1016/j.thromres.2026.109892","DOIUrl":"https://doi.org/10.1016/j.thromres.2026.109892","url":null,"abstract":"<p><strong>Background: </strong>Bleeding risk assessment is critical at the 3-month decision point for extended anticoagulation in patients with pulmonary embolism (PE), yet it remains unclear which existing bleeding risk score best predicts bleeding during the extended phase.</p><p><strong>Methods: </strong>Based on the CURES cohort, this study enrolled patients with PE undergoing extended-phase anticoagulation, which was defined as regular anticoagulant therapy for ≥90 days. We compared the performance of 6 bleeding risk scores (PE-SARD, BACS, Kuijer, RIETE, HAS-BLED, and VTE-BLEED) in predicting major bleeding (MB) events within 1 year during the extended phase. The predictive performance was assessed through time-dependent area under the receiver operating characteristic curves, calibration curves, and decision curve analysis.</p><p><strong>Results: </strong>A total of 4896 patients with acute PE receiving extended-phase anticoagulation were included in the study, among whom 18 patients (0.4%) experienced major bleeding. Compared with the other 5 bleeding scores, VTE-BLEED exhibited the highest predictive accuracy (time-dependent AUC = 0.72; 95% CI: 0.63-0.81), accompanied by superior overall calibration (Brier score = 0.0039). In subgroup analyses by anticoagulant type, VTE-BLEED maintained favorable robustness with AUCs exceeding 0.70 for patients treated with either VKAs or DOACs.</p><p><strong>Conclusions: </strong>VTE-BLEED offers potential utility for guiding risk-stratified management of MB during extended anticoagulation in patients with PE, particularly at the 3-month reassessment point. Nonetheless, the limited number of MB events and follow-up attrition necessitate cautious interpretation and further validation in larger prospective studies.</p>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"266 ","pages":"109892"},"PeriodicalIF":3.4,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149239539","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 and prognostic impact of venous thromboembolism in a prospective single-center cohort of patients with cancer: The THEO study.","authors":"Aram Hovhannisyan, Nicolas Martin, Kamelia Guerda, Elena Pavliuc, Caroline Bailleux, Agnès Ducoulombier, Eva Seutin, Thi-Hong-Van Ngo, Tanguy Pace-Loscos, Jocelyn Gal, Yann Chateau, Clément Devic, Amanda Garrido, Frédéric Peyrade, Emmanuel Chamorey, Victoria Ferrari","doi":"10.1016/j.thromres.2026.109869","DOIUrl":"https://doi.org/10.1016/j.thromres.2026.109869","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) is a major complication in oncology, representing the second leading cause of death among cancer patients after tumor progression. Isolated superficial venous thrombosis (iSVT), historically considered benign, is now emerging as a potential marker of thromboembolic risk but remains underexplored in cancer populations.</p><p><strong>Objective: </strong>To estimate the incidence of VTE and iSVT and evaluate the prognostic impact of VTE on all-cause mortality in a prospective cohort of patients with cancer.</p><p><strong>Methods: </strong>This prospective single-center cohort study included 700 cancer patients at Centre Antoine Lacassagne (Nice, France), followed for 12 months with scheduled visits at 6 and 12 months. VTE (deep vein thrombosis [DVT] or pulmonary embolism [PE]) and iSVT occurring during prospective follow-up were identified and confirmed by imaging. Incidence rates per 1000 person-years and cumulative incidence functions (accounting for death as a competing risk) were calculated. The association between VTE occurring during follow-up and all-cause mortality was assessed using a Cox proportional hazards model with VTE modeled as a time-dependent covariate. The study was registered at ClinicalTrials.gov (NCT03826043).</p><p><strong>Results: </strong>Of 700 enrolled patients, 516 were included in the analysis (median age: 65 years; 53.3% male). During 12 months of follow-up, 50 VTE events occurred (incidence: 147.5 per 1000 person-years), including DVT (110.2 per 1000) and PE (57.1 per 1000). The incidence of iSVT was 25.4 per 1000 person-years, substantially exceeding estimates reported for the general population. In multivariable time-dependent Cox regression adjusted for age, sex, and primary tumor site and stratified by baseline ECOG performance status, VTE was independently associated with an increased risk of all-cause mortality (adjusted HR 2.07, 95% CI 1.36-3.15, p < 0.001).</p><p><strong>Conclusion: </strong>VTE and iSVT incidences in this dedicated cancer center were markedly higher than those reported in general and cancer populations. These findings underscore the need for tailored thromboprophylaxis and closer surveillance in oncology settings.</p>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"266 ","pages":"109869"},"PeriodicalIF":3.4,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246176","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":"Limitations of protamine sulphate for in vitro neutralization of unfractionated heparin in thrombin generation assays.","authors":"Mariangela Costanza, Debora Bertaggia Calderara, Sabine Blum, Lorenzo Alberio, Maxime G Zermatten","doi":"10.1016/j.thromres.2026.109868","DOIUrl":"https://doi.org/10.1016/j.thromres.2026.109868","url":null,"abstract":"","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"266 ","pages":"109868"},"PeriodicalIF":3.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228728","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":"Differential inhibition of bispecific GPVI and CLEC-2 nanobody ligands by a monovalent nanobody","authors":"Vairavan N. Gopalan,&nbsp;Steve P. Watson,&nbsp;Lloyd J. Bridge,&nbsp;Eleyna M. Martin","doi":"10.1016/j.thromres.2026.109840","DOIUrl":"10.1016/j.thromres.2026.109840","url":null,"abstract":"<div><div>We have previously characterised a series of monospecific multivalent nanobodies to the platelet receptors GPVI (Nb2) and CLEC-2 (Nb4) showing that tri- and tetravalent nanobodies induce potent platelet aggregation. In the present study we generated a series of di-, tri- and tetravalent bispecific nanobodies for GPVI and CLEC-2 to mimic ligands such as diesel exhaust particles and polysulphated glycopolymers which crosslink both receptors. In contrast to results with the divalent monospecific nanobodies, the bispecific divalent nanobody, Nb2:Nb4, stimulated weak aggregation in most donors with some donors reaching maximal aggregation over a course of ten minutes. The trivalent nanobodies, Nb2-2:Nb4 (two copies of GPVI nanobody) and Nb2:Nb4‐2 (two copies of CLEC-2 nanobody), and the tetravalent nanobody, Nb2-2:Nb4-2, stimulated full aggregation in all donors. Activation by the trivalent nanobodies was blocked by Src and Syk tyrosine kinase inhibitors. Nb2 (100 nM) is a competitive antagonist against the monospecific tetravalent nanobody, Nb2-4. At the same concentration, Nb2 had a negligible effect on the response to Nb2:Nb4-2 but converted the concentration-response curve for Nb2-2:Nb4 to a bell-shape. Modelling the interaction of trivalent bispecific ligands, composed of two different epitopes, using equilibrium mass action also predicted a differential effect. The results have important implications for inhibiting ligands that crosslink more than one type of receptor.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"266 ","pages":"Article 109840"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary anticoagulation management in pulmonary embolism","authors":"Gary Hammerschlag,&nbsp;Shaun Yo,&nbsp;Emily Lawton,&nbsp;Anna Dunn","doi":"10.1016/j.thromres.2026.109854","DOIUrl":"10.1016/j.thromres.2026.109854","url":null,"abstract":"<div><div>Pulmonary embolism (PE) remains a major cause of cardiovascular morbidity and mortality, but the central management question clinicians increasingly face is not whether to anticoagulate, but how to anticoagulate well. Rapid expansion of the evidence base has transformed anticoagulation management from a largely protocol-driven approach into a more individualised and dynamic model of care.</div><div>Contemporary treatment decisions extend beyond initial drug selection and increasingly require consideration of dose intensity, treatment duration, bleeding phenotype, cancer status, renal function, drug interactions, and evolving thrombotic risk. Direct oral anticoagulants (DOACs) are now established as first-line therapy for most haemodynamically stable patients, while recent studies have refined selection within the DOAC class and challenged traditional assumptions regarding extended therapy.</div><div>Emerging evidence suggests that some patients with apparently strongly provoked venous thromboembolism may nevertheless benefit from prolonged anticoagulation when enduring prothrombotic risk factors persist. Other studies support selective dose reduction during long-term therapy, while highlighting important limitations of this strategy in obesity. In cancer-associated thrombosis, contemporary trials increasingly support dynamic and phenotype-driven approaches to prolonged anticoagulation rather than fixed-duration treatment paradigms.</div><div>This review synthesises evolving evidence on anticoagulation management in PE into a practical framework for clinicians involved in longitudinal venous thromboembolism care. Throughout this review, we distinguish established practice supported by contemporary international guidelines from emerging evidence that may refine future management but has not yet been incorporated into guideline recommendations.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"266 ","pages":"Article 109854"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115312","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":"From APICAT to APICath?","authors":"Philippe Debourdeau,&nbsp;Thifaine Weicker,&nbsp;Théodore Debourdeau","doi":"10.1016/j.thromres.2026.109860","DOIUrl":"10.1016/j.thromres.2026.109860","url":null,"abstract":"","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"266 ","pages":"Article 109860"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149414","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":"Patient adherence and satisfaction with self-administration of prophylactic Low Molecular Weight Heparin (LMWH) after orthopaedic trauma surgery: a prospective observational cohort study.","authors":"E. Horzum,&nbsp;P. Krijnen,&nbsp;J.M. Hoogendoorn,&nbsp;Frederikus A. Klok,&nbsp;I.B. Schipper","doi":"10.1016/j.thromres.2026.109842","DOIUrl":"10.1016/j.thromres.2026.109842","url":null,"abstract":"","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"266 ","pages":"Article 109842"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184228","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}