Cardiovascular
Evaluating the Efficacy of Thromboelastography with Platelet Mapping for Antiplatelet Titration in Peripheral Artery Disease After Lower Extremity Revascularization: A Comprehensive Literature Review Fanah Hagos* Fanah Hagos Dua Anahita Shiv Patel Morrow, Katherine Suarez Ferreira, Sasha Patricia Lee, Ivy
Background: Peripheral artery disease (PAD), affecting over 200 million people globally, has become endemic. Despite the increasing number of operative interventions, the prevalence of limb loss remains high. Objective: This literature review aims to assess the efficacy of Thromboelastography Platelet Mapping (TEG-PM) in titrating antiplatelet therapy post extremity revascularization surgery to prevent thrombosis. Methods: A comprehensive literature search was conducted across Ovid Medline, CINAHL, PubMed, and Google Scholar, using relevant Medical Subject Headings (MeSH) terms, from 2000 to December 2023. Inclusion criteria prioritized diagnostic accuracy, predictive value, and therapeutic implications of TEG parameters in PAD patients. Exclusion criteria ruled out studies unrelated to humans, vascular or endovascular surgery, or lacking sufficient TEG information. Results: The initial search yielded 68 references, with 22 duplicates identified. After screening titles and abstracts of 46 studies, 16 were excluded. Full-text assessment of 30 studies resulted in the inclusion of 15 relevant studies. Key themes emerged, emphasizing TEG-PM’s efficacy in assessing antiplatelet therapy response, predicting thrombotic complications, and guiding personalized titration strategies post revascularization surgery in PAD patients. The studies demonstrated TEG-PM’s ability to identify patients responsive or resistant to antiplatelet medications, facilitating tailored therapeutic interventions. Significant variability in response to mono- and dual antiplatelet therapy in PAD patients undergoing lower extremity revascularization was observed. Conclusion: This literature review highlights the growing role of TEG-PM in shaping antiplatelet titration strategies, studies suggest that TEG-PM can enhance precision in antiplatelet therapy, optimizing outcomes and reducing the risk of thrombotic and bleeding complications.
