Accentuated and irregular post-maximal deflection in thromboelastographic tracings: occurrence in various pathologies

The increased and irregular post-maximal deflection of the two limbs of thromboelastographic traces has been variably interpreted by the Authors who utilize TEG as a global screening test for haemostasis evaluation. These thromboelastographic patterns have been attributed either to enhanced fibrinolytic activity or to raised clot's rectractility or even to incorrect technique. In our study, 1701 TEG's traces carried out in the last five years have been reviewed in order to evaluate the incidence of such patterns in both healthy subjects and in patients affected by different diseases. The data obtained show that such irregular post-maximal deflection's patterns are quite absence in healthy subjects while reaches a statistically significant incidence only in patients affected by diabetes mellitus, obesity or systemic hypertension. The results seem to suggest that the increased and irregular post-maximal TEG deflection is not a simply product of technique's mistake but may represent an useful index of some haemostatic alterations which need further studies.