REVIEW article
Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1668165
Thromboelastography in Ruptured Abdominal Aortic Aneurysm Management: Lessons from Vascular, Cardiac, and Trauma Surgery
Provisionally accepted
- 1Emergency Department, University Clinical Centre, Gdańsk, Poland
- 2Scientific Circle of Neurotraumatology, Medical University of Gdansk, Gdansk, Poland
- 3Department of Vascular Surgery, University Clinical Centre, Gdańsk, Poland
- 4Department of Clinical Nutrition and Dietetics, Medical University of Gdansk, Gdansk, Poland
- 5Home Enteral and Paraenteral Nutrition Unit, Nicolaus Copernicus Hospital, Gdansk, Poland
- 6Department of Emergency Medicine, Medical University of Gdańsk, Gdańsk, Poland
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Ruptured abdominal aortic aneurysm (rAAA) is a critical surgical emergency. Thromboelastography (TEG) is a viscoelastic, point-of-care test that provides a comprehensive real-time assessment of coagulation and fibrinolysis. Although TEG has been successfully adopted in trauma and cardiac surgery for individualised transfusion guidance, its role in rAAA has not been sufficiently explored. We conducted a review of studies published between 2009-2024 to assess the utility of TEG or rotational thromboelastometry (ROTEM) in rAAA management. Evidence from vascular surgery suggests reduced blood-product transfusions and postoperative bleeding. Additional data from cardiac surgery and emergency/trauma demonstrated improved survival, fewer reoperations and cost efficiency. Although there are few direct studies on the utility of TEG in rAAA and these are mostly descriptive, the results presented in this review suggest its potential role in vascular emergencies. To confirm this, well-designed prospective studies are essential to determine when and how TEG should guide decision-making in this critical setting.
Keywords: Thromboelastography, TEG, Rotem, viscoelastic testing, Vascular Surgery, Abdominal Aortic Aneurysm, RAAA, cardiac surgery
Received: 17 Jul 2025; Accepted: 02 Sep 2025.
Copyright: © 2025 Gniedziejko, Halman, Kimilu, Folwarski and Sieminski. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Michał Gniedziejko, Emergency Department, University Clinical Centre, Gdańsk, Poland
Joanna Halman, Department of Vascular Surgery, University Clinical Centre, Gdańsk, Poland
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