Selective angiographic embolization for recurrent elbow and knee haemarthroses in haemophilia: a retrospective case series

Persistent Vascular Remodeling and Leakiness are Important Components of the Pathobiology of Re‐bleeding in Hemophilic Joints: Two Informative Cases

“…Vascular structures on PD assumed large confluent, pulsatile shapes that were described previously and appear unique to hemophilia in that they are absent in normal joints and osteoarthritis and less pronounced in rheumatoid arthritis . Of note, distorted synovial vascular structures resembling pseudoaneurysms in bleeding hemophilic joints were described before in case series during angiography and embolization, providing additional evidence that not only neoangiogenesis but also vascular remodeling is an important feature of progressive hemophilic arthropathy .…”

Guidelines for the management of acute joint bleeds and chronic synovitis in haemophilia

“…Successful control of recurrent bleeding into target joints and improvement of chronic synovitis has been reported using selective angiographic embolization. There are no large studies but the approach may be useful in selected patients.…”

Hemophilic arthropathy: Current knowledge and future perspectives

“…Furthermore, no clinical trials addressing the efficacy of synthetic or biological DMARDs in controlling synovitis have yet been conducted partly because of the lack of sensitive outcome parameters, disease heterogeneity in small populations, and the long follow‐up required. To reduce the burden of inflammation that predisposes to recurrent bleeding by refuelling angiogenesis and synovial hyperplasia, patients with refractory disease may benefit from joint embolisation, 93 or methods of synovial ablation such as chemical synoviorthesis with rifampicin or tetracyclines and radioisotopic synovectomy. 94 , 95 …”