Clot Composition Analysis in Peripheral Arterial Disease: A Systematic Review

Area of Science:

• Vascular Surgery
• Histopathology
• Thromboembolic Disease

Background:

• Peripheral arterial thromboembolic disease causes limb-threatening ischemia.
• Clot composition analysis may reveal thrombus etiology and guide treatment.
• Evaluating thrombi from peripheral interventions is crucial for understanding disease.

Purpose of the Study:

• Systematically review evidence on histopathological and qualitative analysis of thrombi from peripheral arterial interventions.
• Assess the diagnostic and therapeutic impact of clot composition in acute limb-threatening ischemia.
• Synthesize current literature on thrombus evaluation in vascular surgery.

Main Methods:

• Systematic review following PRISMA guidelines.
• Searched PubMed, Embase, and Cochrane CENTRAL databases.
• Qualitative analysis of five included studies on thrombus histopathology.

Main Results:

• Limited and varied histopathological methods were used (mass spectrometry, SEM, biochemical assays).
• No consistent diagnostic or treatment impact of clot composition was identified.
• Data were insufficient for quantitative analysis, highlighting a lack of research.

Conclusions:

• Current evidence does not support routine clot composition analysis in peripheral vascular surgery.
• Significant data gaps exist regarding thrombus histopathology in peripheral arterial thromboembolectomy.
• Further research is needed to define the translational role of clot analysis in vascular surgery.