Related Experiment Video
Updated: Mar 3, 2026
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Total Thrombus-formation Analysis System Predicts Periprocedural Bleeding Events in Patients With Coronary Artery
Yu Oimatsu1, Koichi Kaikita2, Masanobu Ishii1
1Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Insights
Low thrombus formation measured by the platelet chip (PL$_{24}$-AUC$_{10}$) may predict bleeding events after percutaneous coronary intervention. This finding aids in managing bleeding risk in patients with coronary artery disease.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Hemostasis and Thrombosis
Background:
- Periprocedural bleeding is a frequent complication following percutaneous coronary intervention (PCI).
- Thrombogenicity, a measure of blood clot formation, is a key factor in PCI complications.
- Quantitative assessment of thrombogenicity can help predict adverse events.
Purpose of the Study:
- To evaluate the association between quantitative thrombogenicity measurements and periprocedural bleeding events.
- To investigate the predictive value of the Total Thrombus-formation Analysis System (T-TAS) for bleeding complications after PCI.
Main Methods:
- 313 patients undergoing elective PCI were enrolled and categorized by the occurrence of periprocedural bleeding.
- Thrombogenicity was assessed using the T-TAS with platelet (PL) and atheroma (AR) chips, measuring thrombus formation area under the curve (PL$_{24}$-AUC$_{10}$ and AR$_{10}$-AUC$_{30}$).
- Bleeding events were defined as a composite of major and minor bleeding complications.
Main Results:
- Periprocedural bleeding occurred in 37 patients.
- Lower PL$_{24}$-AUC$_{10}$ levels were significantly associated with periprocedural bleeding events (P=0.002).
- This association was significant in the femoral approach group (OR, 2.88; P=0.03) but not in the radial approach group.
Conclusions:
- PL$_{24}$-AUC$_{10}$, measured by the T-TAS, shows potential as a predictor of periprocedural bleeding in PCI patients.
- Quantitative thrombogenicity assessment may aid in risk stratification and management of bleeding complications.
Background:
Periprocedural bleeding events are common after percutaneous coronary intervention. We evaluated the association of periprocedural bleeding events with thrombogenicity, which was measured quantitatively by the Total Thrombus-formation Analysis System equipped with microchips and thrombogenic surfaces (collagen, platelet chip [PL]; collagen plus tissue factor, atheroma chip [AR]).
Methods And Results:
Between August 2013 and March 2016, 313 consecutive patients with coronary artery disease undergoing elective percutaneous coronary intervention were enrolled. They were divided into those with or without periprocedural bleeding events. We determined the bleeding events as composites of major bleeding events defined by the International Society on Thrombosis and Hemostasis and minor bleeding events (eg, minor hematoma, arteriovenous shunt and pseudoaneurysm). Blood samples obtained at percutaneous coronary intervention were analyzed for thrombus formation area under the curve (PL24-AUC10 for PL chip; AR10-AUC30 for AR chip) by the Total Thrombus-formation Analysis System and P2Y12 reaction unit by the VerifyNow system. Periprocedural bleeding events occurred in 37 patients. PL24-AUC10 levels were significantly lower in patients with such events than those without (P=0.002). Multiple logistic regression analyses showed association between low PL24-AUC10 levels and periprocedural bleeding events (odds ratio, 2.71 [1.22-5.99]; P=0.01) and association between PL24-AUC10 and periprocedural bleeding events in 176 patients of the femoral approach group (odds ratio, 2.88 [1.11-7.49]; P=0.03). However, PL24-AUC10 levels in 127 patients of the radial approach group were not significantly different in patients with or without periprocedural bleeding events.
Conclusions:
PL24-AUC10 measured by the Total Thrombus-formation Analysis System is a potentially useful predictor of periprocedural bleeding events in coronary artery disease patients undergoing elective percutaneous coronary intervention.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
01:20Extrinsic and Intrinsic Pathways of Hemostasis
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which...