Thrombodynamics test

Метод тромбодинамики и типичные фотографии роста сгустка

Thrombodynamics test is a diagnostic assay used to evaluate the blood coagulation process in a manner that mimics in vivo conditions more closely than traditional coagulation tests. This test is particularly useful for assessing the risk of thrombosis and hemorrhage, and for monitoring anticoagulant therapy. It provides comprehensive information about the initiation, formation, growth, and dissolution of blood clots, offering a dynamic view of the clotting process.

Overview

The thrombodynamics test is based on the principle of spatial clot growth in a plasma sample, initiated by a small surface that mimics tissue factor exposure. Unlike conventional clotting tests that offer static information (e.g., prothrombin time (PT), activated partial thromboplastin time (aPTT)), thrombodynamics captures the dynamics of clot formation and dissolution over time, providing insights into both the procoagulant and anticoagulant systems of the blood.

Methodology

The test is performed in a specialized device that allows for the real-time observation of clot formation. A plasma sample is placed in a chamber with a tissue factor-bearing surface at one end. The process is visualized using a fluorescently labeled fibrinogen, which incorporates into the forming clot, allowing its growth to be monitored by fluorescence microscopy. The key parameters measured include the rate of clot growth, the maximum size of the clot, and the stability of the clot over time.

Clinical Applications

Thrombodynamics testing has several clinical applications:

• Risk Assessment: It can be used to assess the risk of thrombosis in patients with conditions such as cancer, antiphospholipid syndrome, and inherited thrombophilia.
• Monitoring Therapy: The test is useful for monitoring the efficacy of anticoagulant therapy, including warfarin, direct oral anticoagulants (DOACs), and heparin.
• Research Tool: In the research setting, it helps in understanding the pathophysiology of various coagulation disorders and in the development of new anticoagulant drugs.

Advantages

The thrombodynamics test offers several advantages over traditional coagulation tests:

• It provides a more physiological assessment of clotting by allowing clot formation under flow conditions and in the presence of a tissue factor.
• It can detect both hypercoagulable and hypocoagulable states, making it useful for a wide range of clinical conditions.
• The dynamic nature of the test provides additional information on clot stability and fibrinolysis, which are not available from static tests.

Limitations

Despite its advantages, the thrombodynamics test has some limitations:

• It requires specialized equipment and expertise, limiting its availability to certain specialized laboratories.
• The interpretation of results can be complex and requires a thorough understanding of the coagulation system.

Conclusion

The thrombodynamics test represents a significant advancement in the field of coagulation diagnostics, offering a more dynamic and physiological assessment of the clotting process. Its ability to provide detailed information on clot formation and dissolution makes it a valuable tool for risk assessment, monitoring of therapy, and research into coagulation disorders.