Comprehensive Adult Hemostasis & Thrombosis Center

Our multidisciplinary team of internationally recognized experts specializes in the prevention, diagnosis and treatment of the full range of bleeding and clotting disorders in adults and children, delivering comprehensive, personalized care focused on optimizing health and improving the quality of life for each patient.

For bleeding disorders, we use the most advanced laboratory testing, such as coagulation studies, platelet analysis, clotting-factor assays, genetic testing with massively parallel sequencing and inhibitor testing, as well as tests for other associated medical conditions. For prenatal diagnosis, we also offer advanced noninvasive prenatal screening tests and work together with specialists from our Department of Obstetrics & Gynecology and Women's Health who specialize in performing chorionic villus sampling, amniocentesis and cordocentesis for the collection of circulating fetal cells, as well as sophisticated blastocyst biopsy for preimplantation embryo diagnostics.

Depending on the diagnosis, we offer personalized and targeted treatments. For patients with hemophilia and other bleeding disorders, we offer a wide range of treatments to reduce the incidence of joint, muscle and soft-tissue bleeding and pain and achieve hemostasis and coagulopathy correction, as well as prophylactic treatment such as before dental procedures and before and after surgery to prevent bleeding episodes and improve quality of life. We offer a variety of factor replacement therapies, including human plasma-derived and recombinant clotting-factor concentrates with and without extended half-life to treat and prevent bleeds in people with hemophilia, von Willebrand disease and other rare bleeding disorders. For plasma-derived therapies, including factor concentrates, we use the most advanced screening and viral inactivation techniques to reduce or eliminate bloodborne infections. We also offer bypassing agents to treat bleeding in patients with hemophilia A and B with inhibitors.

We have expertise in administering nonreplacement therapies, including bispecific antibody therapy such as emicizumab, gene and small interfering ribonucleic acid (RNA) therapies, and recombinant clotting-factor therapies that can be used preventatively. While not a cure for hemophilia, these therapies may offer patients peace of mind, more freedom from hemorrhage without the need for regular treatment with drugs, and longer lifespans. Because some of these therapies do not rely on human blood plasma, patients are also not at risk of contracting bloodborne infections, such as hepatitis and human immunodeficiency virus (HIV).

We offer pharmacologic options, including desmopressin (DDAVP) to help reduce bleeding in patients with mild hemophilia and antifibrinolytics such as aminocaproic acid and tranexamic acid to prevent the breakdown of blood clots in people with hemophilia A and B and von Willebrand disease. We also offer pain management using multimodal treatments such as medications, steroids and physical therapy. Hormone therapy, such as birth control pills, is also used to reduce menstrual bleeding in patients with von Willebrand disease.

If surgery is needed to manage bleeding complications like joint bleeding or other soft-tissue concerns, our multidisciplinary team of orthopedic surgeons and surgical specialists provides the latest advancements in open, minimally invasive and robotic surgery.

We also specialize in the diagnosis and treatment of the full range of thrombotic disorders in adults and children, including those leading to venous thromboembolism and arterial thrombosis.

Our doctors conduct thorough prothrombotic risk-factor assessments, identifying concomitant medical comorbidities such as congenital heart defects, solid-organ transplantation and cancer, along with past and family history of blood clots. They also evaluate other risk factors like pregnancy, hormone therapy, immobility, malignancy, infection, obesity, smoking, central venous catheter use and surgical interventions.

We use advanced hypercoagulability testing for congenital thrombophilia disorders, such as antithrombin III deficiency, factor V Leiden mutation, and protein C and S deficiency, and acquired thrombophilia testing, such as antiphospholipid antibody testing, including lupus anticoagulant and IgG/IgM anticardiolipin and serum D-dimer testing. We also offer the latest venous duplex ultrasonography, as well as ventilation-perfusion scans and computed tomography (CT) pulmonary angiography to detect a pulmonary embolus.

Depending on the cause, we offer the latest pharmacological treatments that target procoagulant factors for venous thromboembolism management and antiplatelet agents, either as monotherapy or dual-antiplatelet therapy, for arterial thrombosis management. We use a wide range of anticoagulant agents, including direct oral anticoagulants, such as dabigatran, apixaban, edoxaban and rivaroxaban, vitamin K antagonists like warfarin, and low-molecular-weight heparin.

Our multidisciplinary team of vascular specialists offers a variety of the latest endovascular treatments, including catheter-directed thrombolysis, percutaneous aspiration thrombectomy, venous balloon dilation and pharmacomechanical catheter-directed thrombolysis, administering “clot-busting” drugs directly into the clot. In certain cases, inferior vena cava (IVC) filters, including retrievable IVC filters, are also offered.

If you or your child is newly diagnosed with a bleeding or clotting disorder or currently receiving treatment, our world-renowned team at Montefiore Einstein Hematology (Blood Disorders) is here to provide you with exceptional support, care and resources. Our full-service Center offers a comprehensive range of traditional and holistic care, from screening, prevention and diagnosis to treatment and recovery, including social and support services, genetic counseling and education. Our expansive breadth of resources enables us to deliver highly specialized and coordinated care that considers the whole person, addressing everyone’s complex medical needs and improving quality of life. Our team of compassionate and deeply knowledgeable doctors, nurses, specialists and support staff is dedicated to helping you at every step of your care journey.