Availability of angiography and therapeutic embolization for the treatment of acute bleeding in patients with hemophilia.
Mi Jin KimJi Young OhYoung-Shil ParkPublished in: International journal of hematology (2017)
Clotting factor replacement therapy alone is often inadequate for acute bleeding in hemophilia patients, and surgery for such patients poses significant clinical challenges. Arterial angiographic intervention is used to control bleeding in local blood vessels. In the present study, we examined the clinical course and prognosis of hemophilia patients with bleeding who had undergone angiography, and evaluated the validity of diagnostic angiography and therapeutic embolization in these patients. Angiography was performed in five hemophilia patients, who experienced bleeding that was difficult to control even after treatment with clotting factor replacement or bypassing agent therapy. Of these patients, four were confirmed to have continued bleeding, and angiographic embolization was performed using clotting factor concentrates or bypassing agents. However, one patient developed uncontrollable bleeding at the puncture site, which eventually led to the patient's death. Thus, angiography and therapeutic embolization may be the preferred procedures for the treatment of hemorrhagic complications, refractory to treatment with clotting factor concentrates or bypassing agents. Further comprehensive, multidisciplinary team studies are needed to develop effective strategies to reduce hemorrhagic complications.
Keyphrases
- end stage renal disease
- newly diagnosed
- ejection fraction
- chronic kidney disease
- atrial fibrillation
- computed tomography
- optical coherence tomography
- peritoneal dialysis
- replacement therapy
- randomized controlled trial
- liver failure
- minimally invasive
- stem cells
- risk factors
- case report
- intensive care unit
- palliative care
- hepatitis b virus
- patient reported
- respiratory failure
- ultrasound guided
- cell therapy
- coronary artery bypass