Clinical application of the PFA-100®

Abstract

The PFA-100 (platelet function analyzer) is a relatively new tool for the investigation of primary hemostasis. Recent studies have shown its utility as a screening tool for investigating possible von Willebrand disorder (VWD) and various platelet disorders. More recently, the PFA-100 has been shown to be valuable in monitoring desmopressin acetate (DDAVP) therapy in both VWD and platelet disorders. The PFA-100 has also been evaluated in many other studies for its utility in assessing drug effects, for potential monitoring of antiplatelet medication (including aspirin), or for evaluation of overall primary hemostasis in various clinical disorders or during surgical procedures. This article reviews current findings and highlights the benefits and limitations of the clinical utility of the PFA-100. Ultimately, the greatest strengths of the PFA-100 are its simplicity of use and excellent sensitivity to particular hemostatic disturbances such as VWD, platelet disorders, and platelet-affecting medication. However, because it is thus a global test system, this also creates a significant limitation because the PFA-100 is not specific for, nor predictive of, any particular disorder. However, used appropriately, the PFA-100 can be considered a worthwhile addition to any hemostasis laboratory involved in the diagnosis or therapeutic monitoring of bleeding disorders and potentially of antiplatelet medication. This review should be valuable to both hemostasis scientists and clinical specialists.

Clopidogrel Withdrawal Is Associated With Proinflammatory and Prothrombotic Effects in Patients With Diabetes and Coronary Artery Disease

“…The PFA-100 is a microprocessor-controlled instrument/test cartridge system used to assess platelet function simulating platelet-based primary hemostasis in vitro (15). A syringe aspirates citrated whole blood under high shear-flow conditions (5,000 -6,000 s Ϫ1 ) through a small aperture (150 m) cut into a membrane placed in the test cartridge.…”

“…After 300 s the process automatically terminates. A CEPI-CT Յ193 s (upper normal range limit) has been considered as a cut-off value to define low responders to aspirin and was used accordingly in the present study (15,16 …”

Assessment of platelet aspirin responsiveness in Turkish Population with PFA-100, serum thromboxane B2, soluble CD40 ligand and soluble P-Selectin

“…aspirin) and purinergic receptor inhibitors (e.g. clopidogrel) are being used primarily for arterial disorders which are characterized by high shear rate [21,22]. However, there are many preanalytical factors such as platelet function, platelet count, red blood cells and plasma von Willebrand factor are known to affect the PFA-100 results.…”

Assessment of platelet function: Laboratory and point-of-care methods

“…The time taken to occlude the hole is the closure time (CT), a measure of overall platelet-related haemostasis and this interval will be prolonged depending on the platelet activity. The use of two different cartridges with distinct agonists allows to distinguish the platelet function alterations due to intrinsic defects (principally by using CADP cartridge) or to antiplatelet therapy with ASA (CEPI cartridge) [93][94][95][96][97] , whereas the new Innovance cartridge is affected by thienopyridine therapy [98] . In comparison to BT test, this method is revealed more sensitive [27,46] especially for diagnosis of VWD and platelet function defects [25] .…”