Higher Ratio of Arterial vs Venous Thrombosis in Hemophilia A as Compared with Von Willebrand Disease

Objectives: to investigate the ratio between arterial and venous thrombosis in patients with Hemophilia A or B in comparison with that of patients with von Willebrand Disease.

Methods: analysis of a time unlimited survey of the literature together with an evaluation of personal records. Thrombotic events had to be proven by objective methods. Acquired forms were excluded. 222 patients were found to meet the inclusion criteria, 131 patients with Hemophilia A or B and 91 patients with von Willebrand Disease.

Results: The ratios between arterial and venous thrombosis resulted to be 3.75, 1.12, 2.54 and 1.75, for Hemophilia A, Hemophilia B, combined Hemophilia A and B and von Willebrand Disease, respectively. The difference between Hemophilia A and von Willebrand Disease was statistically significant.

Conclusions: The plasmatic defect present in the Hemophilias, especially in Hemophilia A, seems to protect more from venous rather than from arterial thrombosis. This pattern is less evident for von Willebrand Disease. The clinical significance and the pathogenetic implications of these findings are discussed.