Proposed model aligning the obtained data to recent literature. VWF fibers are tethered to SDC-1 as part of the endothelial glycocalyx. Platelets are trapped by the VWF fibers and further activated in the course of coagulation (eg, through thrombin). Platelet-derived MMPs and HPSE are able to shed the endothelial glycocalyx. Soluble SDC-1 prevents further blood clotting, whereas the endothelial glycocalyx–free endothelial layer promotes the recruitment of immune cells.