Bivalirudin, thrombin and platelets: clinical implications and future directions.

Our current understanding of hemostasis and the roles of coagulation and platelets has evolved in recent years from the old "coagulation cascade" and "platelet pathway" models to an inter-related, cell-based model that more accurately represents in-vivo processes and better reflects clinical observations. The new model makes it apparent that thrombin is a key effector and modulator of hemostasis, and that activation of coagulation and platelets …