jcm-logo

Journal Browser

Journal Browser

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: closed (20 March 2026) | Viewed by 5771

Special Issue Editor


E-Mail Website
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

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 250 words) can be sent to the Editorial Office for assessment.

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. Journal of Clinical Medicine 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 thrombosis
  • biomarkers
  • bleeding
  • direct oral anticoagulants
  • pulmonary embolism
  • factor XI inhibitors
  • factor XII inhibitors
  • endovascular treatment

Benefits of Publishing in a Special Issue

  • Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

Order results
Result details
Select all
Export citation of selected articles as:

Research

Jump to: Review, Other

9 pages, 494 KB  
Article
Deposition of Heavy Metals in Patients with Deep Venous Thrombosis and Healthy Individuals: A Case–Control Study with Laser-Induced Breakdown Spectroscopic Analysis of Nail Edges
by Lutfi Çagatay Onar, Gunduz Yumun, Havva Nur Alparslan Yumun, Muhammed Habib Onen, Didem Melis Oztas and Murat Ugurlucan
J. Clin. Med. 2026, 15(5), 1786; https://doi.org/10.3390/jcm15051786 - 27 Feb 2026
Viewed by 358
Abstract
Background: Deep vein thrombosis (DVT) is one of the most common cardiovascular diseases and is especially prevalent in areas with environmental pollution. Bioaccumulation of toxic heavy metals may lead to deterioration of homeostasis with cellular change, endothelial dysfunction, DNA impairment and cellular [...] Read more.
Background: Deep vein thrombosis (DVT) is one of the most common cardiovascular diseases and is especially prevalent in areas with environmental pollution. Bioaccumulation of toxic heavy metals may lead to deterioration of homeostasis with cellular change, endothelial dysfunction, DNA impairment and cellular signaling. The reason for this is usually the accumulation of thrombogenic toxins in the body as a result of long-term exposure or a lack of regulatory gene expression. In this study, we aimed to measure the minerals that potentially accumulate in the nail. The measurement method was laser-induced breakdown spectroscopy (LIBS), which is a form of atomic emission spectroscopy. It uses a highly energetic laser source to form a plasma of excited atoms emitting light of characteristic wavelengths. It provides accurate quantification and reveals the relationship between tissue accumulation of toxic heavy metals and DVT formation. Methods: Between January 2020 and December 2021, 100 patients diagnosed with lower-extremity deep vein thrombosis were screened in a single tertiary healthcare center. Among them, 50 patients who met the eligibility criteria and consented to participate were included in the study. An additional 50 age-matched healthy volunteers were enrolled as controls. Demographic and clinical characteristics were recorded. Nail samples were obtained from each participant, and elemental emission intensities were quantitatively analyzed using laser-induced breakdown spectroscopy (LIBS). Results: No difference in clinical characteristics was detected between the groups. While iron, calcium and silicon were found to be high in DVT patients, magnesium was found to be low. Regarding the magnesium emission, ROC analysis showed 76–90% specificity and 69–82% sensitivity, respectively. Conclusions: LIBS is a useful method because it is easy to use and can be used with a small sample. According to the results of our study, information about the pathogenesis of DVT was obtained through nail analysis. Therefore, we believe that LIBS analysis is a method that may be useful in determining the causes and predisposing factors for DVT. Full article
(This article belongs to the Special Issue Thrombosis and Haemostasis: Clinical Advances)
Show Figures

Figure 1

Review

Jump to: Research, Other

23 pages, 1038 KB  
Review
Contemporary Challenges in Venous Thromboembolism: Evolving Populations and Implications for Management and Risk Stratification
by Patrick Leung, Prahlad Ho and Hui Yin Lim
J. Clin. Med. 2026, 15(4), 1509; https://doi.org/10.3390/jcm15041509 - 14 Feb 2026
Cited by 1 | Viewed by 663
Abstract
Venous thromboembolism (VTE) remains a major cause of morbidity and mortality globally. The incidence of VTE continues to increase over time, contributed to by demographic shifts and emerging risk factors, such as novel cancer treatments and exposure to gender-affirming hormonal therapies. While the [...] Read more.
Venous thromboembolism (VTE) remains a major cause of morbidity and mortality globally. The incidence of VTE continues to increase over time, contributed to by demographic shifts and emerging risk factors, such as novel cancer treatments and exposure to gender-affirming hormonal therapies. While the introduction of direct oral anticoagulants (DOACs) revolutionized VTE management, increasing complexity in select patient cohorts has driven the need for alternative treatment strategies, including pharmacological and interventional approaches. Concurrently, contemporary patient populations have exposed limitations in existing risk assessment models, highlighting the need for revision and consideration of novel biomarkers. In this review, we provide an overview of the changing VTE landscape, highlighting emerging risk factors, advances in treatment, and the utility of current risk stratification tools and novel biomarkers in guiding care. Full article
(This article belongs to the Special Issue Thrombosis and Haemostasis: Clinical Advances)
Show Figures

Figure 1

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
Cited by 1 | Viewed by 2714
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)
Show Figures

Figure 1

Other

Jump to: Research, Review

14 pages, 626 KB  
Systematic Review
Machine Learning Models for Predicting Bleeding Risk in Anticoagulated Patients with Atrial Fibrillation and Venous Thromboembolism: A Comparative Evidence Synthesis
by Winnie Z. Y. Teo, Maggie Wing Yin Wong, Fang Jin Lim, Emmeliene Su-Min Ong, Nesaretnam Barr Kumarakulasinghe and Eng Soo Yap
J. Clin. Med. 2026, 15(6), 2370; https://doi.org/10.3390/jcm15062370 - 20 Mar 2026
Viewed by 442
Abstract
Background: Accurate prediction of bleeding events in patients receiving oral anticoagulants remains a key challenge in the management of atrial fibrillation (AF) and venous thromboembolism (VTE). Machine learning (ML) algorithms have emerged as powerful tools that capture complex, nonlinear interactions among risk factors, [...] Read more.
Background: Accurate prediction of bleeding events in patients receiving oral anticoagulants remains a key challenge in the management of atrial fibrillation (AF) and venous thromboembolism (VTE). Machine learning (ML) algorithms have emerged as powerful tools that capture complex, nonlinear interactions among risk factors, potentially offering superior accuracy. Objectives: To synthesize evidence comparing ML-based bleeding risk models with conventional clinical scores in anticoagulated AF and VTE populations. Methods: We conducted a systematic review with narrative synthesis of studies published between 2015 and 2025 applying ML algorithms to predict bleeding events in anticoagulated AF or VTE patients. Results: Thirteen studies were identified (seven AF and six VTE), including 464,523 participants in total. ML algorithms such as random forest (RF), extreme gradient boosting (XGBoost), and neural networks consistently outperformed traditional tools. In AF, AUCs ranged from 0.64 to 0.76 compared to 0.52–0.61 for HAS-BLED. In VTE, ML models achieved 0.59–0.91 versus 0.61–0.65 for RIETE or VTE-BLEED. Deep learning ensembles reached the highest AUCs (>0.8). Conclusions: ML-based bleeding risk models demonstrated statistically superior discrimination compared to established scores in both AF and VTE contexts, but effect sizes were modest (ΔAUC 0.05–0.15) and clinical utility remains uncertain. Broader validation, calibration assessment, and demonstration of impact on clinical outcomes are necessary before routine adoption. Full article
(This article belongs to the Special Issue Thrombosis and Haemostasis: Clinical Advances)
Show Figures

Figure 1

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
Cited by 2 | Viewed by 1023
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)
Show Figures

Figure 1

Back to TopTop