Availability of peripheral inserted central catheters in severe hemophilia patients with inhibitors |
Youngshil Park |
Department of Pediatrics, East-West Neo Medical Center, College of Medicine, Kyung Hee University, Seoul, Korea |
중증 혈우병 항체 환자에서 시행한 말초삽입 중심혈관 카테터의 유용성 |
박영실 |
경희대학교 의과대학 동서신의학병원 소아청소년과 |
Correspondence:
Youngshil Park, Email: pysmd@khnmc.or.kr |
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Abstract |
The most effective treatment strategy for patients with hemophilia is replacement therapy with FVIII or FIX concentrates, which usually requires long-term, uncomplicated venous access. However, central venous access device (CVADs, ports) insertion requires inpatient admission and general anesthesia, and presents some problems regarding health insurance coverage. Peripherally inserted central catheters (PICCs) were inserted in two severe hemophilia patients aged 7 and 11 years with high titers of inhibitors. They experienced frequent bleeding episodes and required replacement therapy, which eventually resulted in difficulty in acquiring venous line access. Factor VIII activity was below 1%, and inhibitor titers were 160 and 26.3 BU/ml. In an outpatient setting, PICC lines are easily placed by radiological guidance and require local anesthesia alone. PICC has been feasible, in particular, for hemophilia patients with frequent bleeding episodes. |
Key Words:
Hemophilia, Peripherally inserted central catheter |
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