J Thromb Thrombolysis. 2026 Oct 25. doi: 10.1007/s11239-026-03420-2. Online ahead of print.
ABSTRACT
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.
PMID:42927563 | DOI:10.1007/s11239-026-03420-2