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Published on: June 4, 2020
A multicenter clinical evaluation of the Clot Signature Analyzer
W Fricke1, P Kouides, C Kessler
1Department of Internal Medicine, Georgetown University, Washington, DC, USA. william.fricke@viahealth.org
Insights
The Clot Signature Analyzer (CSA) effectively screens for bleeding disorders, detecting abnormalities in 89% of patients with conditions like von Willebrand disease and coagulation factor deficiencies. This global hemostasis assay shows high sensitivity for diagnosing hemostatic impairments.
Area of Science:
- Hematology
- Diagnostic Assays
- Hemostasis Research
Background:
- The Clot Signature Analyzer (CSA) is a novel instrument designed for global hemostasis assessment.
- It functions as a screening assay utilizing non-anticoagulated whole blood.
- The CSA generates three key measurements: platelet hemostasis time (PHT), clot time (CT), and collagen-induced thrombus formation (CITF).
Purpose of the Study:
- To establish normal reference ranges for CSA measurements.
- To evaluate the diagnostic performance of the CSA in patients with known hemostatic disorders.
- To compare CSA performance in patient cohorts versus healthy control subjects.
Main Methods:
- A multi-institutional study involving four participating centers.
- Each institution established its own normal reference ranges for CSA parameters.
- Patients with well-characterized hemostatic disorders and healthy controls were enrolled and analyzed.
Main Results:
- Normal ranges showed similarity across institutions, with statistically significant differences noted.
- The study analyzed 108 patients with various bleeding disorders, including von Willebrand disease (VWD), coagulation factor deficiencies, and platelet function defects, plus patients on anticoagulation.
- CSA detected at least one abnormality in 89% of these patients, demonstrating high sensitivity.
- Of 116 normal subjects, 89% fell within the established normal ranges.
Conclusions:
- The Clot Signature Analyzer (CSA) demonstrates significant potential as a sensitive screening tool for a wide spectrum of bleeding disorders.
- The assay effectively identifies hemostatic abnormalities in patients with conditions such as VWD and coagulation factor deficiencies.
- CSA performance suggests its utility in clinical settings for the initial assessment of hemostatic function.
Background:
The Clot Signature Analyzer (CSA) was designed to assess global hemostasis as a screening assay using non-anticoagulated whole blood. Three different measurements are produced by the instrument: platelet hemostasis time (PHT), clot time (CT), and collagen-induced thrombus formation (CITF).
Objectives:
The purpose of the present study was to determine normal ranges for these measurements and assess the performance of the CSA in patients with well-characterized hemostatic disorders and in normal subjects.
Patients And Methods:
Four institutions participated in the study. Each established their own normal reference ranges. Patients with well-characterized hemostatic disorders and concurrent normal controls were subsequently examined.
Results:
Normal ranges between institutions were similar although statistically different. One hundred and eight patients were examined: 46 individuals with von Willebrand disease (VWD) (type 1, 26; type 2A, 11; type 2B, six; type 3, three); 38 patients with a coagulation factor deficiency; 13 individuals with platelet function defects; 10 patients taking warfarin; and one individual on low-molecular-weight heparin. Of these patients, 89% had at least one abnormality by CSA: 42/46 VWD patients, 35/38 coagulation protein defect patients, 9/13 patients with platelet function defects, 9/10 patients on warfarin and 1/1 patient on low-molecular-weight heparin. Of 116 normal subjects, 103 (89%) fell within the centers' normal range. These data suggest that the CSA has a good sensitivity for bleeding disorders.
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