A new TENS study protocol proposes using a modified low-dose tissue plasminogen activator thromboelastometry test to stratify venous thromboembolism risk within 30 days after neurosurgery. The trial is designed to evaluate whether lysis time from the assay can identify patients at higher risk earlier than standard approaches. Separately, clinicians and researchers are also tracking how perioperative and patient-level factors shape outcomes after major interventions, highlighting the field’s move toward earlier, test-driven risk stratification. For biotech and diagnostics, these protocol-level advances matter because they determine what diagnostic performance claims are likely to be pursued and what endpoints—such as imaging-confirmed VTE—future products would need to support.