{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T02:18:19Z","timestamp":1773109099590,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,11,19]],"date-time":"2020-11-19T00:00:00Z","timestamp":1605744000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Objectives<\/jats:title><jats:p>Slow\u2010flow vascular malformations are abnormal vessels that can lead to activation and consumption of coagulation factors and thrombosis, known as localized intravascular coagulopathy (LIC). Most clinical and research evidence of vascular malformation hemostasis relies on conventional coagulation studies, which may not provide a complete picture. Thromboelastograpy (TEG) is a tool that can provide real\u2010time assessment of a patient's coagulation dynamics, and may allow for a more individualized treatment approach. We hypothesized that patients with slow\u2010flow vascular malformations will have changes in TEG parameters peri\u2010procedure that will help predict blood product or medication administration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design\/Methods<\/jats:title><jats:p>Institutional Review Board approved prospective study of patients with slow\u2010flow vascular malformations undergoing a sedated, minor procedure. TEG and conventional coagulation studies were obtained preprocedure, 15\u00a0min, and when possible, at 30\u00a0min after the start of the procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010five patients were enrolled. Median age was 15\u00a0years (range 3\u201047\u00a0years). Procedures included laser and\/or sclerotherapy. There were no changes in TEG parameters from baseline to 15\u00a0min or 30\u00a0min. The following decreased from baseline to 15\u00a0min: fibrinogen 313 to 287\u00a0mg\/dL (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001), D\u2010dimer 1.3 to 1.1\u00a0mg\/L (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.02), hemoglobin 12.8 to 11.8\u00a0g\/dL (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001), and platelet count 272\u00a0000 to 256\u00a0000 (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.006). No patient had a bleeding\/thrombotic complication during or within 1\u00a0week postprocedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We saw no change in TEG parameters or bleeding or clotting complications despite significant numerical changes in conventional coagulation profiles, suggesting that conventional studies may not be as useful in determining risks of bleeding or thrombotic complications peri\u2010procedure for minor procedures.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.28824","type":"journal-article","created":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T05:35:43Z","timestamp":1605850543000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Analyzing coagulation dynamics during treatment of vascular malformations with thromboelastography"],"prefix":"10.1002","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3893-4709","authenticated-orcid":false,"given":"Joana M.","family":"Mack","sequence":"first","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Hematology\u2010Oncology University of Arkansas for Medical Sciences Little Rock Arkansas"},{"name":"Arkansas Children's Hospital Little Rock Arkansas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. D'ann","family":"Pierce","sequence":"additional","affiliation":[{"name":"Arkansas Children's Hospital Little Rock Arkansas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gresham T.","family":"Richter","sequence":"additional","affiliation":[{"name":"Arkansas Children's Hospital Little Rock Arkansas"},{"name":"Department of Surgery, Division of Otolaryngology University of Arkansas for Medical Sciences Little Rock Arkansas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beverly J.","family":"Spray","sequence":"additional","affiliation":[{"name":"Arkansas Children's Research Institute Little Rock Arkansas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Nicholas","sequence":"additional","affiliation":[{"name":"Arkansas Children's Hospital Little Rock Arkansas"},{"name":"Department of Surgery, Division of Orthopedic Surgery University of Arkansas for Medical Sciences Little Rock Arkansas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. Spencer","family":"Lewis","sequence":"additional","affiliation":[{"name":"Arkansas Children's Hospital Little Rock Arkansas"},{"name":"Department of Radiology, Division of Interventional Radiology University of Arkansas for Medical Sciences Little Rock Arkansas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Becton","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Hematology\u2010Oncology University of Arkansas for Medical Sciences Little Rock Arkansas"},{"name":"Arkansas Children's Hospital Little Rock Arkansas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5133-9624","authenticated-orcid":false,"given":"Shelley E.","family":"Crary","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Hematology\u2010Oncology University of Arkansas for Medical Sciences Little Rock Arkansas"},{"name":"Arkansas Children's Hospital Little Rock Arkansas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.144.7.873"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.38311"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2018.01.015"},{"key":"e_1_2_9_5_1","article-title":"Abnormal hemostasis in children with vascular anomalies, part I: thrombocytopenias among different vascular anomalies","author":"Tole S","year":"2019","journal-title":"Thromb Res"},{"key":"e_1_2_9_6_1","first-page":"181","article-title":"Venous malformation and localized intravascular coagulopathy in children","volume":"27","author":"Hung JW","year":"2017","journal-title":"Eur J Pediatr Surg"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1258\/phleb.2009.009041"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MBC.0000000000000412"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2017.11.030"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23599"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4939-7196-1_39"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2257.2005.00681.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001608"},{"key":"e_1_2_9_14_1","first-page":"34","article-title":"Detection of coagulopathy in chronic renal disease using thromboelastography and its comparison with conventional tests","volume":"67","author":"Pandey CK","year":"2019","journal-title":"J Assoc Physicians India"},{"key":"e_1_2_9_15_1","first-page":"153","article-title":"Evaluation of coagulation disorders with thrombelastography in patients with sepsis]","volume":"28","author":"Zhong S","year":"2016","journal-title":"Zhonghua Wei Zhong Bing Ji Jiu Yi Xue"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqz074"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8191.2009.00840.x"},{"key":"e_1_2_9_18_1","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1051\/ject\/201749283","article-title":"TEG\u2010directed transfusion in complex cardiac surgery: impact on blood product usage","volume":"49","author":"Fleming K","year":"2017","journal-title":"J Extra Corpor Technol"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199902000-00016"},{"key":"e_1_2_9_20_1","doi-asserted-by":"crossref","first-page":"151","DOI":"10.4103\/aca.ACA_174_17","article-title":"Utility of thromboelastography versus routine coagulation tests for assessment of hypocoagulable state in patients undergoing cardiac bypass surgery","volume":"21","author":"Sharma S","year":"2018","journal-title":"Ann Card Anaesth"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27896"},{"key":"e_1_2_9_22_1","first-page":"297","article-title":"Current management of venous malformations]","volume":"33","author":"Redondo P","year":"2010","journal-title":"An Sist Sanit Navar"}],"container-title":["Pediatric Blood &amp; 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