Acute arterial thrombosis in hemophilia with inhibitory antibodies

Shutov S.A.; Danishyan K.I.; Shutova A.S.; Yatsyk G.A.

doi:https://doi.org/10.17116/hirurgia202201197

Shutov S.A.

National Research Center for Hematology

SPIN RSCI: 8698-8529
Scopus AuthorID: 16239780800
ORCID: 0000-0002-5347-2947

Danishyan K.I.

National Medical Research Center for Hematology

Shutova A.S.

National Medical Research Center for Hematology

Yatsyk G.A.

National Medical Research Center for Hematology

Acute arterial thrombosis in hemophilia with inhibitory antibodies

Authors:

Shutov S.A., Danishyan K.I., Shutova A.S., Yatsyk G.A.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2022;(1): 97‑102

DOI: 10.17116/hirurgia202201197

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To cite this article:

Shutov SA, Danishyan KI, Shutova AS, Yatsyk GA. Acute arterial thrombosis in hemophilia with inhibitory antibodies. Pirogov Russian Journal of Surgery. 2022;(1):97‑102. (In Russ.)
https://doi.org/10.17116/hirurgia202201197

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

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Abstract:

The authors demonstrate an importance of personalized approach to perioperative hemostatic therapy in a 48-year-old patient with hemophilia A and inhibitory antibodies. Laparoscopic hernia repair and extraction of 15 decayed teeth were performed. Hemostatic therapy included AICC and rFVIIa. Postoperative period was complicated by acute thrombosis of splenic artery and partial spleen infarction. An essential factor in splenic artery thrombosis was increase in blood coagulation potential under rFVIIa administration and depletion of fibrinolytic system (prolongation of XIIa-dependent fibrinolysis from 25 to 75 min) and antithrombin III decrease up to 81%. Cancellation of hemostatic therapy under TEG control ensured fast regression of arterial thrombosis and preservation of spleen. Individual characteristics of patients (compensatory mechanisms of coagulation, comorbidities, clinical changes) should be considered when prescribing hemostatic therapy in hemophilia patients. Perioperative control of all possible coagulation tests (routine and integral) is required for individual selection of hemostatic therapy and decrease of the risk of hemorrhagic and thrombotic complications.

Keywords:

hemophilia

inhibitor

acute arterial thrombosis

spleen infarction

thromboelastography

Authors:

Shutov S.A.

National Research Center for Hematology

SPIN RSCI: 8698-8529
Scopus AuthorID: 16239780800
ORCID: 0000-0002-5347-2947

Danishyan K.I.

National Medical Research Center for Hematology

Shutova A.S.

National Medical Research Center for Hematology

Yatsyk G.A.

National Medical Research Center for Hematology

Received:

18.02.2021

Accepted:

18.03.2021

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References:

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