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Thrombosis and Haemostasis: Clinical Advances

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Vascular Medicine".

Deadline for manuscript submissions: 20 March 2026 | Viewed by 771

Special Issue Editor


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Guest Editor
1. Department of Haematology, Northern Pathology Victoria, Northern Hospital, Epping, VIC 3076, Australia
2. Northern Clinical Diagnostics and Thrombovascular Research (NECTAR) Centre, Northern Health, Epping, VIC 3076, Australia
3. Department of Medicine (Northern Health), University of Melbourne, Epping, VIC 3076, Australia
4. Australian Centre for Blood Diseases, Monash University, Melbourne, VIC 3004, Australia
5. School of Health and Biomedical Sciences, RMIT—The Royal Melbourne Institute of Technology, Melbourne, VIC 3000, Australia
Interests: venous thrombosis; thrombosis; cardiovascular disease; anticoagulation

Special Issue Information

Dear Colleagues,

In patients with a first episode of unprovoked VTE, the risk of recurrence can be as high as 25% at five years and 36% at 10 years. Although continued anticoagulation reduces the risk of recurrence, it must be carefully weighed against the risk of bleeding, estimated at 1–4% per year. Existing prediction models for predicting first VTE, subsequent recurrence, and bleeding risks have methodological limitations and insufficient predictive accuracy. A personalised risk assessment and tailored anticoagulation management is crucial to prevent recurrence without unnecessarily putting lower-risk patients at increased risk of anticoagulation-related bleeding. Beyond the recommended minimal duration of anticoagulation, there is no universally recommended long-term duration of anticoagulation, as the risk-benefit differs between individuals. The addition of novel biomarkers in combination with clinical risk assessment models may improve the clinician’s ability to predict such risks at an individual level.

While direct oral anticoagulants (DOACs) have revolutionised anticoagulation management in VTE, the use of DOACs, including the duration and optimal dosing in the setting of patients with cardiovascular comorbidities (e.g., stable atherosclerosis disease, renal impairment), is still under debate. Furthermore, there is increasing interest in targeting other upstream coagulation factors, such as the inhibition of factors XI and XII, as alternative anticoagulation agents with potentially lower bleeding risks. Another area of highlight is the treatment approach for intermediate-risk PE, in which our understanding of best practises remains limited. There is emerging evidence demonstrating improved short-term outcomes following endovascular treatments, but there remains a paucity of evidence of the safety and efficacy of these approaches compared to conservative therapies in the short and long term.

In this Special Issue, we welcome authors to submit papers that address the current and future state of the art in the management of venous and arterial thrombosis.

Dr. Hui Yin Lim
Guest Editor

Manuscript Submission Information

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Keywords

  • venous thrombosis
  • biomarkers
  • bleeding
  • direct oral anticoagulants
  • pulmonary embolism
  • factor XI inhibitors
  • factor XII inhibitors
  • endovascular treatment

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Published Papers (2 papers)

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Review

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20 pages, 1334 KB  
Review
Emerging Thrombolysis Technologies in Vascular Thrombosis
by Bingwen Eugene Fan, Yixin Jamie Kok, Chuen Wen Tan, Yu Yue Hew, Brandon Jin An Ong, Benjamin Yong-Qiang Tan, Winnie Z. Y. Teo, Rinkoo Dalan, Yen Lin Chee and Eng Soo Yap
J. Clin. Med. 2025, 14(21), 7758; https://doi.org/10.3390/jcm14217758 - 1 Nov 2025
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Abstract
Background/Objectives: Thrombotic diseases, such as ischemic stroke, acute myocardial infarction, and venous thromboembolism, are leading causes of global morbidity and mortality. Traditional thrombolytic therapies like systemic tissue plasminogen activator (tPA) are limited by bleeding risks, poor targeting, and inconsistent efficacy. This review [...] Read more.
Background/Objectives: Thrombotic diseases, such as ischemic stroke, acute myocardial infarction, and venous thromboembolism, are leading causes of global morbidity and mortality. Traditional thrombolytic therapies like systemic tissue plasminogen activator (tPA) are limited by bleeding risks, poor targeting, and inconsistent efficacy. This review explores emerging non-pharmacological technologies aimed at overcoming these challenges through targeted, minimally invasive thrombolysis. Methods: A narrative synthesis of recent advancements was conducted, focusing on six innovative approaches: ultrasound-mediated thrombolysis (UMT), microrobots, electrothrombectomy, photothrombectomy, magnetic targeted thrombolysis, and nanotechnology. Preclinical and clinical studies were reviewed to assess mechanisms, efficacy, safety, and translational potential, prioritizing technologies with demonstrated success in animal or early human trials. Results: Technologies like microbubble-enhanced UMT, magnetically actuated microrobots, and fibrin-targeted nanoparticles showed promising results. UMT improved recanalization in ischemic stroke and pulmonary embolism, while electrothrombectomy demonstrated safe, effective clot extraction in human trials. However, challenges remain in scalability, biocompatibility, and clinical integration, with microrobots and photothrombectomy still in preclinical stages. Conclusions: Emerging thrombolysis technologies offer safer, more targeted alternatives to conventional treatments. Clinical adoption will depend on overcoming translational hurdles, including large-scale trials, miniaturization, and interdisciplinary collaboration, with a focus on hybrid approaches and real-time imaging integration. Full article
(This article belongs to the Special Issue Thrombosis and Haemostasis: Clinical Advances)
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Other

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14 pages, 1136 KB  
Study Protocol
Monitoring and Follow-Up of Patients on Vitamin K Antagonist Oral Anticoagulant Therapy Using Artificial Intelligence: The AIto-Control Project
by Adolfo Romero-Arana, Nerea Romero-Sibajas, Elena Arroyo-Bello, Adolfo Romero-Ruiz and Juan Gómez-Salgado
J. Clin. Med. 2025, 14(20), 7191; https://doi.org/10.3390/jcm14207191 - 12 Oct 2025
Viewed by 323
Abstract
Background: Vitamin K antagonist oral anticoagulant (VKA) therapy, using warfarin or acenocoumarol in our health system, is indicated, according to clinical guidelines, for the prophylaxis of thromboembolic events. In Málaga, the VKA patient management program currently includes a total of 856 patients. [...] Read more.
Background: Vitamin K antagonist oral anticoagulant (VKA) therapy, using warfarin or acenocoumarol in our health system, is indicated, according to clinical guidelines, for the prophylaxis of thromboembolic events. In Málaga, the VKA patient management program currently includes a total of 856 patients. Hypothesis: The use of an AI-based application can enhance treatment adherence among VKA patients participating in self-monitoring and self-management programs. Furthermore, it can support the comprehensive implementation of the system, leading to reduced costs and fewer interventions for anticoagulated patients. Methods: The study will be conducted in several phases. The first phase involves the development of the application and the integration of Artificial Intelligence (AI) and Machine Learning (ML) algorithms. The second phase includes preliminary testing and validation of the developed application. The third phase consists of full implementation, along with an assessment of user-identified needs and potential quality improvements. Expected Results: The implementation of the AIto-Control app is expected to reduce healthcare-related costs by decreasing primary care visits and hospital admissions due to thromboembolic or bleeding events. Additionally, it aims to ease the workload on both primary care and hospital services. These outcomes will be achieved through the involvement of advanced practice nurses who will supervise app-based monitoring and patient education. Full article
(This article belongs to the Special Issue Thrombosis and Haemostasis: Clinical Advances)
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