Nevertheless, in older patients, those with a history of thrombotic manifestations, and patients with high-risk factors (male sex, splenectomy, exposure to IVIg, systemic lupus erythematosus, or antiphospholipid syndrome), clinicians should evaluate and monitor the risk of thrombotic events and CTEPH when treating ITP patients with TPO-Ras, especially those with a history of splenectomy, to identify any early signs of CTEPH and to implement appropriate preventive measures. This evidence concerns the gene TPO and antiphospholipid syndrome.