Clot characterization by multidisciplinary approach: biochemical and imaging parameters in a hypocoagulative setting. A pilot study.

https://doi.org/10.4081/jphr.2021.2358
  • Francesco Marongiu
    Hemostasis and Thrombosis Unit, Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Dimitrios Marco Ntoukas
    Hemostasis and Thrombosis Unit, Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Luigi Barberini
    Department of Medical Sciences and Public Health, University of Cagliari, Italy. https://orcid.org/0000-0002-3815-0392
  • Maria Filomena Ruberto
    Hemostasis and Thrombosis Unit, Department of Medical Sciences and Public Health, University of Cagliari, Italy. https://orcid.org/0000-0001-9491-1734
  • Maria Sebastiana Piras
    Hemostasis and Thrombosis Unit, Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Maria Conti
    Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Italy.
  • Maria Luisa Di Martino
    Internal Medicine Unit, Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Mario Mura
    Internal Medicine Unit, Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Silvia Marongiu
    Internal Medicine Unit, SS Trinità Hospital, Azienda Tutela della Salute, Cagliari, Italy.
  • Maria Luigia Vannini
    Hemostasis and Thrombosis Unit, Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Mattia Lillu
    Internal Medicine Unit, Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Monica Piras
    Anatomic-Pathology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Daniela Fanni
    Anatomic-Pathology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Lara Fenu
    Hemostasis and Thrombosis Unit, Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Carmen Porcu
  • Doris Barcellona
    Hemostasis and Thrombosis Unit, Department of Medical Sciences and Public Health, University of Cagliari, Italy. https://orcid.org/0000-0002-0823-3357
  • Gavino Faa
    SHRO Temple University, Philadelphia, PA, United States.
  • Terenzio Congiu
    Anatomic-Pathology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Italy.

ABSTRACT

Background: Clot characterization is, to the present days, a multimodal approach: scanning the clot by electron microscopy (SEM) is helpful for the visualization of fibrin structure along with laboratory parameters such as the clot waveform analysis (CWA) and thrombin generation in different settings of clot abnormalities. This study aimed to assess whether the coagulative parameters were consistent with the clot images texture acquired by SEM, and therefore to propose a more generalist and integrative approach to clots classification.

Design and Methods: In this pilot study, the examined population consists of eight healthy subjects, seven patients affected by Acquired Hemophilia A (AHA) and seven patients treated with Vitamin K Antagonists (VKAs), similar for age and gender. We studied the velocity and acceleration (1st and 2nd derivative of the aPTT) of clot formation (CWA), the thrombin generation, and the clots' scanning by SEM. Images acquired with SEM were then analyzed with the MATLAB software with the “Texture Analysis” methods to perform classification. Among the various texture parameters, we reported Contrast and Energy.

Results: Significant differences among healthy subjects, patients with AHA and those treated with VKAs were detected for the coagulative parameters. We found no differences between VKAs and AHA patients. Contrast and energy highlighted a significant difference among the three groups in agreement with the laboratory's parameters. We found no significant differences between VKAs and AHA patients.

Conclusions: The use of SEM, CWA and thrombin generation parameters may be a starting point for studies aimed to demonstrate the general characteristics of clot formation in different clinical conditions with a multiparametric approach.

AUTHOR BIOGRAPHIES

Daniela Fanni, Anatomic-Pathology Unit, Department of Medical Sciences and Public Health, University of Cagliari

SHRO Temple University, Philadelphia, PA, USA

Doris Barcellona, Hemostasis and Thrombosis Unit, Department of Medical Sciences and Public Health, University of Cagliari

SHRO Temple University, Philadelphia, PA, USA

Gavino Faa, SHRO Temple University, Philadelphia, PA

Anatomic-Pathology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Italy

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