Clot network analysis framework guided by spectrally-encoded confocal microscopy (SECM) in cardiac critical care patients

Vascular thrombosis is a major cause of death and disability globally. Current treatments are limited by an incomplete understanding of clot mechanics. We developed a fiber-network analysis framework to predict clot shear modulus (G) based on microstructural parameters, including fiber density, length, radius, and spatial heterogeneity. To validate the model, we compared its shear-modulus predictions to bedside coagulation monitor (iCoagLab) measurements from LVAD patients, achieving agreement within ±12%. The framework successfully reproduced a ~25% reduction in clot stiffness seen in patients with high heparin levels by simulating a 15% decrease in fiber straightness, illustrating how micro-architectural shifts translate into clinically recognized mechanical changes. By mapping how anticoagulation alters network architecture, this microstructure-based framework may inform more precise antithrombotic strategies and improve the management of acute thrombosis.