The Utility of Total Thrombus-Formation Analysis System (T-TAS) in the Thrombosis and Hemostasis Field: A Scoping Review

BACKGROUND: A wide variety of laboratory hemostasis tests is available, but the majority is plasma-based, static and unable to assess platelet function and fibrin formation simultaneously. The Total Thrombus-Formation Analysis System (T-TAS) is a microchip-based flow chamber system that simulates in vivo conditions for evaluating whole blood thrombogenicity. AIM: A comprehensive overview of its applicability in different thrombosis and hemostasis related clinical situations is lacking and therefore this scoping review was performed. MATERIALS & METHODS: A literature search was done using the electronic databases PubMed, Scopus and Embase on January 7, 2024. Original studies assessing the usefulness of the T-TAS in thrombosis and hemostasis related clinical situations were eligible for this scoping review. RESULTS: A total of 28 studies were included; six studies investigating the role of the T-TAS in congenital bleeding disorders, five studies using the T-TAS to assess 1-year bleeding risk in patients on antiplatelet or anticoagulant medications, four studies investigating the effects of thrombocytopenia and hemodialysis on thrombus formation as measured by the T-TAS, 11 studies testing the applicability of the T-TAS in the monitoring of anticoagulant and antiplatelet therapies and eventually two studies on the ability of the T-TAS to assess the thrombogenicity in different disease entities. DISCUSSION & CONCLUSION: The T-TAS method is an interesting technology that mimics the complex biological coagulation process using shear forces, creating a "blood vessel component on a chip". More research is needed, but it could eventually function as a screening test for platelet function and coagulation. Moreover, it could be used to detect the presence of anticoagulant and/or antiplatelet medication.