I. Thrombelastography Overview Thrombelastography TEG was invented by German Harter in 1948 as a kind of analyzer for dynamic monitoring of the whole picture of coagulation and overall evaluation of coagulation and fibrinolytic process. At the same time, it is also an important tool for blood product management in advanced countries around the world. Second, the working principle and parameters of TEG The final process of coagulation is the formation of blood clots, clots in the formation and dissolution process will cause changes in physical elasticity, strength, which is the basic principle of TEG test, which can dynamically reflect the coagulation factors, fibrin, platelet function and fibrinolysis. The test simulates slow venous blood flow in vitro, induces clot formation by adding activators, determines the time and number of clot formation with receptors, and plots the clotting speed and strength curve by computer. Third, the main difference between TEG and conventional coagulation test Conventional coagulation test indicators such as: prothrombin time (PT), partial thromboplastin time (APTT), fibrinogen (FIB) or D-Dimer are only one part of the examination of isolated plasma and coagulation cascade reaction. Since platelets and other blood cells are removed from the plasma during the assay and several other non-physiological substances or non-physiological concentrations of substances are added to promote or amplify the clot formation process, it can only simulate in vitro endogenous or exogenous coagulation bypass pathways, or fibrinolytic fractions, fragments or partial tracing of the coagulation process. Therefore, it does not reproduce the in vivo coagulation situation. The results are often influenced by heparin-like substances. TEG, on the other hand, provides a complete monitoring of the whole process from the beginning of coagulation to clot formation and fibrinolysis in one blood sample. The results are available in 15-20 minutes with automatic diagnostic function. Fourth, TEG in the field of vascular surgery application prospects 1, for the important supplement to the conventional coagulation test, to guide individualized anticoagulation therapy anticoagulation therapy is the cornerstone of the treatment of vascular disease, the rational use of anticoagulant drugs is to ensure that the patient’s vascular smooth fundamental, the traditional coagulation test PT and APTT can only detect the activity of procoagulant factors, and the balance between procoagulation and anticoagulation is actually more important, in order to achieve scientific and reasonable In order to achieve scientific and rational individualized anticoagulation, monitoring of the whole coagulation picture is necessary. For example, heparinase contrast assay of thromboelastography is commonly used in the perioperative period to determine heparin resistance, monitor heparinization and evaluate the neutralization effect of fisetin on heparin, which has obvious advantages over traditional APTT monitoring. 2. Rivaroxaban, for example, is favored by more and more clinicians because of its precise anticoagulant effect, no routine monitoring of coagulation, little influence of diet, no need for dose adjustment, and convenient out-of-hospital application. However, since rivaroxaban antagonists are not yet available on the market and the determination of factor Xa activity required to evaluate its risk is not yet included in the routine testing program in many hospitals, the assessment of its efficacy and bleeding risk is still an issue that we need to pay attention to. The R-value provided by thromboelastography is a sensitive parameter for responding to clotting time and is expected to play a guiding role in the assessment of efficacy and safety of new oral anticoagulant drugs. 3. Assessment of the therapeutic effect of antiplatelet drugs Platelet activation plays an important role in the development of atherosclerosis and thrombosis; therefore, antiplatelet drugs are particularly important in the treatment of peripheral atherosclerotic occlusive diseases. TEG PlateletMapping can assess the efficacy of antiplatelet drugs and predict the risk of bleeding and thrombosis in patients, which can help to guide individualized antiplatelet therapy and thus reduce the risk of thrombosis and bleeding. 4.Evaluate bleeding in the perioperative period or during treatment, and guide component transfusion The thromboelastography test can determine the specific cause of bleeding, and can basically determine the causes of coagulation factors, fibrin and platelets cause to identify, and also can reduce the risk of secondary surgery. Many countries in Europe and the United States use TEG as an important tool for blood product management, and the literature shows that TEG-guided transfusions help to save blood, reduce side effects and death due to over-transfusion or bleeding due to heparin residues, and thus guide transfusion of the correct blood components and hemostatic treatment. By the rate of postoperative bleeding. 5. Determining the perioperative blood hypercoagulation status for individualized thromboprophylaxis The significance of antithrombotic drugs for thromboprophylaxis and treatment is self-evident, however, bleeding side effects limit their use in perioperative patients, and exactly when to start anticoagulation in such patients has been a problem in front of vascular surgeons. Thromboelastography, because of its rapidity and ability to reflect the full picture of human coagulation, can determine whether perioperative patients with thrombotic risk factors are in a hypercoagulable or hypocoagulable state, thus enabling individualized thromboprophylaxis. In conclusion, thromboelastography, as an important supplement to traditional coagulation tests, will be recognized by more and more clinicians and play an important role in antithrombotic therapy.