{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T19:30:37Z","timestamp":1769801437869,"version":"3.49.0"},"reference-count":44,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"crossref","award":["RF-2010-2317993"],"award-info":[{"award-number":["RF-2010-2317993"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100009874","name":"Regione Autonoma Friuli Venezia Giulia","doi-asserted-by":"crossref","award":["40250\/2017"],"award-info":[{"award-number":["40250\/2017"]}],"id":[{"id":"10.13039\/501100009874","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biosensors"],"abstract":"<jats:p>Hemostasis depends on the coordinated interaction between platelets, coagulation factors, endothelium, and shear forces. Current point-of-care (POC) assays evaluate isolated components of haemostasis or operate under nearly static conditions, limiting their ability to reproduce physiological thrombus formation. In this study, we performed the technical validation of Smart Clot, a fully automated, microfluidic POC platform that quantifies platelet aggregation, fibrin formation, and total thrombus growth under controlled arterial shear using unmodified whole blood. Recalcified citrated blood was perfused over collagen at \u03b3\u02d9w = 300 s\u22121. Dual-channel epifluorescence microscopy acquired platelet and fibrin(ogen) signals at 1 frame per second. Integrated Density time-series were fitted with a five-parameter logistic model; first derivatives and their integrals yielded standardized pseudo-volumes for platelets, fibrin(ogen), and total thrombus. Sixty-two healthy donors established reference distributions; one-hundred-thirteen patients on antithrombotic therapy assessed pharmacodynamic sensitivity. Platelet-derived parameters were approximately normally distributed, whereas fibrin(ogen) and total thrombus values followed log-normal patterns. Anticoagulants and antiplatelet agents produced graded, mechanism-consistent inhibition of all thrombus components. Cardiopulmonary bypass samples showed profound but transient suppression of platelet and fibrin activity. Across activity ranges, multiple statistical assessments supported high analytical repeatability. Smart Clot provides rapid, reproducible, flow-aware quantification of platelet\u2013fibrin dynamics, capturing pharmacological modulation and peri-operative impairment with high sensitivity. These results support its potential as a next-generation POC assay for physiological hemostasis assessment.<\/jats:p>","DOI":"10.3390\/bios16020080","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T17:40:22Z","timestamp":1769622022000},"page":"80","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Smart Clot: An Automated Point-of-Care Flow Assay for Quantitative Whole-Blood Platelet, Fibrin, and Thrombus Kinetics"],"prefix":"10.3390","volume":"16","author":[{"given":"Alessandro","family":"Foladore","sequence":"first","affiliation":[{"name":"Sedicidodici s.r.l., 33170 Pordenone, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Lattanzio","sequence":"additional","affiliation":[{"name":"Sedicidodici s.r.l., 33170 Pordenone, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7476-2823","authenticated-orcid":false,"given":"Ekaterina","family":"Baryshnikova","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, 20097 San Donato Milanese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7132-2782","authenticated-orcid":false,"given":"Martina","family":"Anguissola","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, 20097 San Donato Milanese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3688-9281","authenticated-orcid":false,"given":"Elisabetta","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Stem Cell Unit, Department of Research and Advanced Cancer Diagnostic, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Valvasori","sequence":"additional","affiliation":[{"name":"Stem Cell Unit, Department of Research and Advanced Cancer Diagnostic, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1899-064X","authenticated-orcid":false,"given":"Roberto","family":"Vettori","sequence":"additional","affiliation":[{"name":"Stem Cell Unit, Department of Research and Advanced Cancer Diagnostic, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2808-9348","authenticated-orcid":false,"given":"Francesco","family":"Agostini","sequence":"additional","affiliation":[{"name":"Stem Cell Unit, Department of Research and Advanced Cancer Diagnostic, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Tassan Toffola","sequence":"additional","affiliation":[{"name":"Unit of Transfusion Medicine in Oncology, Department of Transfusion Medicine, Azienda Sanitaria Friuli Occidentale, 33170 Pordenone, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lidia","family":"Rota","sequence":"additional","affiliation":[{"name":"Sedicidodici s.r.l., 33170 Pordenone, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4915-3572","authenticated-orcid":false,"given":"Marco","family":"Ranucci","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, 20097 San Donato Milanese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8319-053X","authenticated-orcid":false,"given":"Mario","family":"Mazzucato","sequence":"additional","affiliation":[{"name":"Stem Cell Unit, Department of Research and Advanced Cancer Diagnostic, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1182\/blood.V88.5.1525.1525","article-title":"Platelets and Shear Stress","volume":"88","author":"Kroll","year":"1996","journal-title":"Blood"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1161\/01.ATV.0000193624.28251.83","article-title":"What Does It Take to Make the Perfect Clot?","volume":"26","author":"Monroe","year":"2006","journal-title":"Arterioscler. 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