Cerebral venous thrombosis (CVT) is an uncommon form of stroke that predominantly affects younger adults. Anticoagulation remains the cornerstone of treatment. Direct oral anticoagulants (DOACs) offer practical advantages over vitamin K antagonists (VKAs), but controlled-trial evidence remains limited. To evaluate the efficacy and safety of DOACs compared with VKA-based standard care in patients with CVT. We conducted a systematic review and random-effects meta-analysis of eligible controlled trials reported by their investigators as randomized. The primary efficacy outcome was radiological recanalization or improvement at approximately 6 months, and the primary safety outcome was major bleeding. Risk ratios (RRs) with 95
Transcatheter aortic valve implantation (TAVI) has expanded into younger and lower-risk patients, making long-term valve durability increasingly important. Leaflet thrombosis, most commonly identified on computed tomography as hypoattenuated leaflet thickening (HALT), is common after TAVI. Whether leaflet thrombosis contributes to structural valve deterioration (SVD) remains incompletely understood. To summarize the current evidence on the relationship between leaflet thrombosis and SVD after TAVI, with a focus on clinical outcomes, imaging findings, antithrombotic therapy, and pathophysiological mechanisms. This narrative review synthesizes available clinical, imaging, mechanistic, histopathological and antithrombotic literature addressing leaflet thrombosis and valve durability after TAVI. CT studies show that leaflet thrombosis occurs in 13-32
Unfractionated Heparin (UFH) is widely used to treat multiple conditions in hospitalized patients. Standard dosing based on actual body weight (ABW) may lead to over-anticoagulation in overweight patients due to the limited vascularity of adipose tissue. Historically, ABW was used when BMI ≤ 40 kg/m2, and adjusted body weight (AdjBW) when BMI > 40 kg/m2. However, patients with ABW >130
Percutaneous mechanical thrombectomy is now widely used for iliofemoral deep vein thrombosis (DVT) and intermediate-risk pulmonary embolism (PE) across several device platforms, and every procedure yields intact human thrombus that is routinely discarded. Whether this material can be developed into a translational resource linking thrombus biology to clinical outcome has not been systematically addressed. A narrative, non-systematic review was performed. PubMed/MEDLINE, Scopus, Web of Science and the Cochrane Library were searched (January 2010 to August 2026) for studies addressing the biology, histopathology and translational analysis of mechanically retrieved venous thrombi, supplemented by reference-list, trial-registry and congress hand-searching. Published venous series remain small and largely confined to descriptive histology, disconnected from longitudinal outcomes. Intra-thrombus biology could address venous-specific questions that peripheral biomarkers and imaging alone cannot: post-thrombotic syndrome, incomplete recanalization, chronic thromboembolic pulmonary hypertension and cancer-associated thrombosis. A device-agnostic framework is proposed, comprising structured intra-procedural sampling at the level of the case rather than the anatomical region, centralized specimen processing under harmonized quality standards, a tiered analytic pipeline anchored on quantitative immunohistochemistry, paired peripheral-biomarker collection, pre-specified hypotheses with feasibility-based sample sizes, and biobank infrastructure embedded in existing trial platforms. The equivalent programme in arterial thrombectomy supplies transferable methodology, subject to explicit boundary conditions. The retrieved venous thrombus is among the more underused translational specimens in vascular medicine. A standardized, registry-embedded characterization framework could accelerate progress toward precision venous thrombosis medicine. Mechanical thrombectomy, across multiple device platforms, generates a growing volume of retrievable human venous thrombus that is almost always discarded. Retrieved venous thrombi remain characterized largely by descriptive histology, without systematic immunothrombotic or molecular profiling and without linkage to longitudinal outcome. Neutrophil extracellular traps are proposed as the entry point rather than the whole model: they combine a defined prothrombotic and antifibrinolytic mechanism, a quantifiable tissue assay, a matched circulating assay and a druggable node. Specimen fragmentation makes in-situ orientation unrecoverable in most cases, so a realistic programme rests on case-level sampling, centralized quantitative immunohistochemistry and paired plasma, with spatial methods reserved for a well-preserved subset. Implications for future directions: registry-embedded translational sub-studies with pre-specified hypotheses, harmonized quality standards, a central analytic core facility and a tiered site structure represent a feasible next step toward precision venous thrombosis medicine.
