Objective:

To examine the diagnostic effectiveness of thromboelastography (TEG) in conjunction with traditional coagulation assessments for lower limb deep vein thrombosis (DVT) after cerebrovascular surgical procedures conducted between January 2024 and February 2026.

Key Findings:

• Postoperative DVT incidence was 46.5% (87/187).
• DVT cohort had a higher median age (67.0 vs. 60.5 years, p = 0.001) and greater hypertension prevalence (66.7% vs. 46.0%, p = 0.007).
• Postoperative Angle (72.3° vs. 69.4°, p = 0.001) and D-dimer levels (812 μg/L vs. 254 μg/L, p < 0.001) were significantly higher in the DVT cohort.
• Independent predictors for DVT included age, Angle, D-dimer, and hypertension.
• The combined diagnostic model showed an AUC of 0.836, with high specificity (86.0%) and sensitivity (70.1%).

Interpretation:

The integration of TEG with traditional coagulation tests significantly enhances the diagnostic capability for DVT post-cerebrovascular surgery, particularly in identifying at-risk patients, which is crucial for timely intervention.

Limitations:

• Single-center study may limit generalizability.
• Retrospective design may introduce selection bias, and potential confounding factors were not fully controlled.

Conclusion:

TEG combined with standard coagulation assessments provides a valuable tool for early DVT diagnosis post-surgery, supporting targeted anticoagulation strategies, which is essential for improving patient outcomes.