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Venous Thrombosis (DVT/VTE): From Bench to Bedside

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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 August 2020) | Viewed by 13853

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Special Issue Editor

Prof. Dr. Alexander Brill

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Guest Editor

1. Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
2. Department of Pathophysiology, Sechenov First Moscow State Medical University, Moscow, Russia
Interests: thrombosis; vascular biology; cardiovascular diseases; deep vein thrombosis (DVT); stroke
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Special Issue Information

Dear Colleagues,

Venous thromboembolism (VTE), consisting of deep vein thrombosis (DVT) and its major complication, pulmonary embolism (PE), is a serious health issue worldwide. Mechanisms of DVT development are substantially different from arterial thrombosis and remain incompletely understood. In particular, recent studies have demonstrated the pivotal role of different components of the immune system and local inflammatory responses (such as neutrophil extracellular traps or mast cells) in DVT initiation. Research using animal models has demonstrated multiple novel molecules that might be useful for venous thrombosis prediction (biomarkers) and targets potentially beneficial for venous thrombosis prevention in clinical setting. Another fundamental and clinical problem is venous thrombus recanalization and resolution, which develops more similarly to the wound healing process than to classic fibrinolysis.

Current prevention of VTE is largely based on inhibition of blood coagulation factors, which lead to bleeding in a proportion of patients. Therefore, fundamentally new or existing but improved therapeutic modalities are urgently needed.

This Special Issue is devoted to a discussion of new insights into mechanisms of DVT initiation, progression, and resolution, as well as recent achievements in its diagnostics, prophylaxis, and treatment in the clinical setting. It will include but is not limited to the following subtopics:

Animal models of venous thrombosis;
Mechanisms of venous thrombosis initiation;
The role of the immune system and inflammation in venous thrombosis;
Mechanisms of venous thrombosis resolution;
Classic and emerging novel biomarkers of venous thrombosis and others;
Risk factors and diagnostics of VTE;
Prophylaxis of DVT and PE;
Treatment of VTE;
Course and treatment of DVT complications, such as post-thrombotic syndrome.

This is the conjunct Special Issue both in IJMS and Diagnostics. Authors are free to choose the journal they would like to submit to based on their submission topic.

Prof. Dr. Alexander Brill
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Venous thromboembolism (VTE)
Deep vein thrombosis (DVT)
Pulmonary embolism (PE)
Thrombus resolution
Immune system
Inflammatory response
Novel molecules
Biomarkers
New targets
Diagnostics, preventions, and treatment of VTE and its complications

Published Papers (3 papers)

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Research

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10 pages, 263 KiB

Open AccessArticle

Coagulation Profiles of Pulmonary Arterial Hypertension Patients, Assessed by Non-Conventional Hemostatic Tests and Markers of Platelet Activation and Endothelial Dysfunction

by Eleni Vrigkou, Argyrios E. Tsantes, Petros Kopterides, Stylianos E. Orfanos, Apostolos Armaganidis, Eirini Maratou, Evdoxia Rapti, Athanasios Pappas, Andreas G. Tsantes and Iraklis Tsangaris

Diagnostics 2020, 10(10), 758; https://doi.org/10.3390/diagnostics10100758 - 27 Sep 2020

Cited by 12 | Viewed by 2841

Abstract

Many pathophysiologic processes of pulmonary arterial hypertension (PAH), namely, excess vasoconstriction, vascular remodeling and in situ thrombosis, involve the coagulation cascade, and more specifically, platelets. The aim of this study was to globally assess coagulation processes in PAH, by using non-conventional hemostatic tests, along with markers of platelet activation and endothelial dysfunction. We studied 44 new PAH patients (22 with idiopathic PAH and 22 with connective tissue disease) and 25 healthy controls. The following tests were performed: platelet function analyzer-100 (PFA-100), light transmission aggregometry (LTA), rotational thromboelastometry (ROTEM), endogenous thrombin potential (ETP), serotonin, thromboxane A2 and p-selectin plasma levels, and von Willebrand antigen (VWF:Ag) and activity (VWF:Ac). Our results showed that PAH patients had diminished platelet aggregation, presence of disaggregation, defective initiation of the clotting process and clot propagation, and diminished thrombin formation capacity. Serotonin, thromboxane A2 and p-selectin levels were increased, and VWF:Ag and VWF:Ac decreased in the same population. The results of this study suggest that the platelets of PAH patients are activated and present functional abnormalities. The procoagulant activity, in general, appears to be impaired probably due to a sustained and prolonged activation of the procoagulant processes. Larger observational studies are warranted to confirm these laboratory findings. Full article

(This article belongs to the Special Issue Venous Thrombosis (DVT/VTE): From Bench to Bedside)

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13 pages, 3908 KiB

Open AccessArticle

A Finite Element Analysis Study from 3D CT to Predict Transcatheter Heart Valve Thrombosis

by Francesco Nappi, Laura Mazzocchi, Irina Timofeva, Laurent Macron, Simone Morganti, Sanjeet Singh Avtaar Singh, David Attias, Antonio Congedo and Ferdinando Auricchio

Diagnostics 2020, 10(4), 183; https://doi.org/10.3390/diagnostics10040183 - 26 Mar 2020

Cited by 15 | Viewed by 4382

Abstract

Background: Transcatheter aortic valve replacement has proved its safety and effectiveness in intermediate- to high-risk and inoperable patients with severe aortic stenosis. However, despite current guideline recommendations, the use of transcatheter aortic valve replacement (TAVR) to treat severe aortic valve stenosis caused by degenerative leaflet thickening and calcification has not been widely adopted in low-risk patients. This reluctance among both cardiac surgeons and cardiologists could be due to concerns regarding clinical and subclinical valve thrombosis. Stent performance alongside increased aortic root and leaflet stresses in surgical bioprostheses has been correlated with complications such as thrombosis, migration and structural valve degeneration. Materials and Methods: Self-expandable catheter-based aortic valve replacement (Medtronic, Minneapolis, MN, USA), which was received by patients who developed transcatheter heart valve thrombosis, was investigated using high-resolution biomodelling from computed tomography scanning. Calcific blocks were extracted from a 250 CT multi-slice image for precise three-dimensional geometry image reconstruction of the root and leaflets. Results: Distortion of the stent was observed with incomplete cranial and caudal expansion of the device. The incomplete deployment of the stent was evident in the presence of uncrushed refractory bulky calcifications. This resulted in incomplete alignment of the device within the aortic root and potential dislodgment. Conclusion: A Finite Element Analysis (FEA) investigation can anticipate the presence of calcified refractory blocks, the deformation of the prosthetic stent and the development of paravalvular orifice, and it may prevent subclinical and clinical TAVR thrombosis. Here we clearly demonstrate that using exact geometry from high-resolution CT scans in association with FEA allows detection of persistent bulky calcifications that may contribute to thrombus formation after TAVR procedure. Full article

(This article belongs to the Special Issue Venous Thrombosis (DVT/VTE): From Bench to Bedside)

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Review

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19 pages, 1000 KiB

Open AccessReview

Advances in the Diagnosis of Venous Thromboembolism: A Literature Review

by Harish Patel, Haozhe Sun, Ali N. Hussain and Trupti Vakde

Diagnostics 2020, 10(6), 365; https://doi.org/10.3390/diagnostics10060365 - 02 Jun 2020

Cited by 20 | Viewed by 6077

Abstract

The incidence of venous thromboembolism (VTE), including lower extremity deep vein thrombosis (DVT) and pulmonary embolism (PE) is increasing. The increase in suspicion for VTE has lowered the threshold for performing imaging studies to confirm diagnosis of VTE. However, only 20% of suspected cases have a confirmed diagnosis of VTE. Development of pulmonary embolism rule-out criteria (PERC) and update in pre-test probability have changed the paradigm of ruling-out patient with low index of suspicion. The D-dimer test in conjunction to the pre-test probability has been utilized in VTE diagnosis. The age appropriate D-dimer cutoff and inclusion of YEARS algorithm (signs of the DVT, hemoptysis and whether PE is the likely diagnosis) for the D-dimer cutoff have been recent updates in the evaluation of suspected PE. Multi-detector computed tomography pulmonary angiography (CTPA) and compression ultrasound (CUS) are the preferred imaging modality to diagnose PE and DVT respectively. The VTE diagnostic algorithm do differ in pregnant individuals. The prerequisite of avoiding excessive radiation has recruited planar ventilation-perfusion (V/Q) scan as preferred in pregnant patients to evaluate for PE. The modification of CUS protocol with addition of the Valsalva maneuver should be performed while evaluating DVT in pregnant individual. Full article

(This article belongs to the Special Issue Venous Thrombosis (DVT/VTE): From Bench to Bedside)

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