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CC BY 4.0 · TH Open 2021; 05(03): e400-e410
DOI: 10.1055/s-0041-1732341
Original Article

Global Thrombosis Test: Occlusion by Coagulation or SIPA?

Viviana Clavería  ‡   *
1   GWW School of Mechanical Engineering, Institute for Bioengineering and Biosciences, Georgia Institute of Technology, Atlanta, Georgia, United States
,
Patricia J. Yang‡   *
1   GWW School of Mechanical Engineering, Institute for Bioengineering and Biosciences, Georgia Institute of Technology, Atlanta, Georgia, United States
,
Michael T. Griffin
1   GWW School of Mechanical Engineering, Institute for Bioengineering and Biosciences, Georgia Institute of Technology, Atlanta, Georgia, United States
,
David N. Ku
1   GWW School of Mechanical Engineering, Institute for Bioengineering and Biosciences, Georgia Institute of Technology, Atlanta, Georgia, United States
› Author Affiliations Funding The study is funded by Atlanta Center for Microsystems Engineered Point-of-Care Technologies, ACME-POCT with funding number of NIH-5U54EB027690.
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Abstract

The global thrombosis test (GTT) is a point of care device that tests thrombotic and thrombolytic status. The device exposes whole blood flow to a combination of both high and low shear stress past and between ball bearings potentially causing thrombin and fibrin formation. The question arises as to whether thrombosis in the GTT is dominated by coagulation-triggered red clot or high shear-induced white clot. We investigated the nature of the thrombus formed in the GTT, the device efficacy, human factors use, and limitations. The GTT formed clots that were histologically fibrin-rich with trapped red blood cells. The occlusion time (OT) was more consistent with coagulation than high shear white clot and was strongly lengthened by heparin and citrate, two common anticoagulants. The clot was lysed by tissue plasminogen activator (tPA), also consistent with a fibrin-rich red clot. Changing the bead to a collagen-coated surface and eliminating the low shear zone between the beads induced a rapid OT consistent with a platelet-rich thrombus that was relatively resistant to heparin or tPA. The evidence points to the GTT as occluding primarily due to fibrin-rich red clot from coagulation rather than high shear platelet aggregation and occlusion associated with arterial thrombosis.

Keywords

GTT thrombosis - point-of-care - coagulation - SIPA - shear rate

* V.C. and P.J.Y. contributed equally as co-first authors.




Publication History

Received: 18 February 2021

Accepted: 16 June 2021

Article published online:
19 September 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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