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Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

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Related Experiment Video

Updated: Jul 2, 2026

The Nijmegen Hemostasis Assay: Simultaneous Fluorogenic Measurement of Thrombin and Plasmin Generation in a Single Well

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Published on: February 27, 2026

Sex Differences in Thrombin Generation Using Calibrated Automated Thrombogram in Patients With Peripheral Artery

Shria Bucha¹, Isabella Ferlini Cieri², Adriana Rodriguez²

¹Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.

The Journal of Surgical Research

|June 30, 2026

Summary

Women with peripheral artery disease (PAD) show faster thrombin generation after revascularization. This highlights the need for sex-specific antithrombotic strategies in PAD patients.

Keywords:

Anticoagulant medications Antiplatelet medications Antithrombotic therapies Hypercoagulability Peripheral arterial disease Revascularization outcomes Sex differences Thrombin generation

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Published on: March 21, 2025

Area of Science:

Vascular Surgery
Hematology
Pharmacology

Background:

Thromboprophylaxis efficacy in peripheral artery disease (PAD) patients post-revascularization is unclear.
Sex-based differences in physiological responses to treatment require further investigation.

Purpose of the Study:

To examine sex-specific differences in thrombin generation after lower extremity revascularization in PAD patients.
To assess the impact of sex on thrombin generation dynamics and its relation to clinical outcomes.

Main Methods:

Prospective observational cohort study of 93 PAD patients (≥60 years) undergoing lower extremity revascularization.
Thrombin generation assessed using calibrated automated thrombogram (calibrated automated thrombogram) at baseline and 1 month.
Analysis included sex stratification and comparison of thrombin generation parameters (lag time, peak thrombin, thrombin generation rate, endogenous thrombin potential).

Main Results:

At 1 month, females exhibited significantly higher thrombin generation rates, peak thrombin, and shorter lag times compared to males.
Thrombin generation rate correlated with major adverse limb events.
Females showed inadequate thrombin suppression across various antithrombotic regimens, a pattern persisting up to 6 months.

Conclusions:

Female PAD patients exhibit persistently accelerated thrombin generation post-revascularization.
Findings support the necessity for sex-specific antithrombotic strategies in PAD management.