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Semin Thromb Hemost 2023; 49(06): 592-599
DOI: 10.1055/s-0042-1756706
Review Article

Clot Waveform Analysis for Monitoring Hemostasis

Keiji Nogami
1   Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan
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Abstract

Clot waveform analysis (CWA) is a recently developed global coagulation assessment, based on the continuous observation of changes in light transmittance, absorbance, or light scattering that occurs as fibrin formed in a plasma sample during routine clotting tests such as activated partial thromboplastin time (aPTT) and prothrombin time (PT). CWA can utilize qualitative waveform patterns as well as sensitive quantitative parameters and can be used as a simple method to assess global hemostasis, and can be applied to various challenging clinical situations. Although not all coagulation analyzers currently in use are able to provide CWA, the number of analyzers available to do so is increasing, as the usefulness of this process has become more widely recognized. CWA can be based on the coagulation mechanism of aPTT, an intrinsic trigger, and this has been reported in many studies, including diagnosis and treatment of patients with hemophilia, disseminated intravascular coagulation, and monitoring of anticoagulants and thrombosis. CWA using trace amounts of tissue factors also has the potential to expand the applications of this technology. Recently, there have been reports of the combined evaluation of fibrinolytic dynamics. Among the existing global coagulation assays, CWA may prove to be the easiest to standardize in clinical practice. However, more extensive testing using standardized methods in various clinical settings is needed to determine the true role of CWA in the evaluation of hemostasis and thrombosis in the future.

Keywords

activated partial thromboplastin time - clot waveform analysis - coagulation - fibrinolysis - hemophilia

Author's Contribution

K.N. wrote the manuscript, edited the manuscript, and approved the final version to be published.




Publication History

Article published online:
29 September 2022

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