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Semin Thromb Hemost
DOI: 10.1055/a-2603-0344
Review Article

Thrombotic Complications in Hemophilia: An Intricate Conundrum

Massimo Franchini
1   Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Mantua, Italy
,
Daniele Focosi
2   North-Western Tuscany Blood Bank, Pisa University Hospital, Pisa, Italy
,
Pier Mannuccio Mannucci
3   Fondazione IRCCS Ca'Granda-Ospedale Maggiore Policlinico and University of Milan, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
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Abstract

Hemophilia A and hemophilia B are rare genetic disorders characterized by low plasma levels of coagulation factor VIII or factor IX, resulting in a bleeding tendency with a clinical severity proportional to the degree of the clotting factor deficiency. Although rare, hemophilia patients can paradoxically experience thrombotic events that complicate the clinical picture and the management by physicians operating at hemophilia treatment centers. Such thromboembolic complications, which can involve either the arterial or the venous districts, recognize various causes, including aging (due to the progress of care during the last three decades) and inherited and acquired (treatment-related) risk factors. These determinants often interact with each other to increase patients' susceptibility to thrombosis. In this narrative review, we summarize the current knowledge on the mechanisms, clinical presentation, and management of thrombotic complications in hemophilia patients.

Keywords

hemophilia - thrombosis - cardiovascular disease - therapy

Authors' Contributions

M.F. and P.M.M. co-wrote the article. D.F. and P.M.M. revised the article.




Publication History

Received: 22 April 2025

Accepted: 08 May 2025

Accepted Manuscript online:
08 May 2025

Article published online:
23 May 2025

© 2025. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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