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Updated: Apr 18, 2026
In Vitro Thrombosis Test for Ventricular Assist Devices
Published on: March 21, 2025
New developments in pediatric venous thromboembolism and anticoagulation, including the target-specific oral
Courtney A Lyle1, Robert F Sidonio, Neil A Goldenberg
1aDepartment of Pediatrics, Billings Clinic, Billings, Montana bDepartment of Pediatrics, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia cJHM Pediatric Thrombosis Program, All Children's Hospital, Johns Hopkins Medicine, St. Petersburg, Florida dJohns Hopkins Children's Center and Division of Hematology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA *Coutney A. Lyle and Robert F. Sidonio contributed equally to the writing of this article.
Insights
Identifying risk factors for pediatric venous thromboembolism (VTE) aids prevention. While target-specific oral anticoagulants (TSOACs) show promise, their safety and efficacy in children require further study.
Area of Science:
- Pediatric Hematology
- Thrombosis Research
- Pharmacology
Background:
- Pediatric venous thromboembolism (VTE) affects children of all ages, leading to significant morbidity.
- Current management involves pharmacologic intervention and ongoing research into novel prevention and treatment strategies.
Purpose of the Study:
- To review recent advancements in pediatric VTE prevention and treatment.
- To explore risk-stratified prevention strategies, optimized anticoagulation, and the role of target-specific oral anticoagulants (TSOACs) in children.
Main Methods:
- Review of recent research on pediatric VTE.
- Analysis of risk factors for hospital-acquired VTE.
- Evaluation of current anticoagulation optimization and TSOACs in pediatric populations.
Main Results:
- Improved understanding of hospital-acquired VTE risk factors for risk-stratified prevention.
- Enhanced insights into optimizing conventional anticoagulants for neonates and children with inflammatory conditions.
- Emerging data on TSOAC use in children, with ongoing clinical trials assessing safety and efficacy.
Conclusions:
- Identification of VTE risk factors can inform pediatric VTE prevention strategies.
- TSOACs show initial promise for pediatric VTE, but further investigation into their safety and efficacy is necessary.
Purpose Of Review:
Pediatric venous thromboembolism (VTE) can affect children of all ages, requiring considerable pharmacologic intervention and is often associated with significant morbidity. Current research efforts are directed toward the development of risk-stratified VTE prevention strategies employing pharmacologic thromboprophylaxis, the optimization of conventional anticoagulation, and the investigation of the safety and efficacy of target-specific oral anticoagulants (TSOACs) in children.
Recent Findings:
Recent research has considerably improved the understanding of risk factors of hospital-acquired VTE and how these factors may be employed in risk-stratified paradigms for VTE prevention in children. Additional insight has been gained in the optimization of conventional anticoagulants in special populations such as neonates and children with inflammatory conditions, and in improving the overall safety and compliance with periprocedural anticoagulation and the use of home International Normalized Ratio monitoring. Furthermore, the use of TSOACs has been described in children and is the focus of numerous ongoing clinical trials that are evaluating the safety and efficacy of these agents in children with VTE.
Summary:
Identification of hospital-acquired VTE risk factors may inform pediatric VTE prevention strategies. Although initial use of TSOACs may be promising, investigation of safety and efficacy in children is still underway.
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