Surgical Complications in a Hemophilia Patient With Factor VIII Inhibitor and Their Endovascular Management

Hemophilia, an X-linked disorder due to clotting factors VIII or IX deficiency, is associated with recurrent hemorrhage into joints, soft tissue, and organs. Recombinant factor VIII concentrates are available for the treatment of bleeding complications. However, inhibitors to factor VIII develop in 25% to 35% of patients with severe hemophilia A, making the management of bleeding episodes more complex. The treatment of unusual metachronous ruptured aneurysms in a patient with hemophilia A with factor VIII inhibitor is presented, and the outcomes of endovascular and open operations are discussed.

[1]  L. Valentino FEIBA prophylaxis for patients with haemophilia and inhibitors , 2006 .

[2]  V. Blanchette,et al.  Prevention and treatment of musculoskeletal disease in the haemophilia population: role of prophylaxis and synovectomy , 2006, Haemophilia : the official journal of the World Federation of Hemophilia.

[3]  F. Lafeber,et al.  Pathogenesis of haemophilic arthropathy , 2006, Haemophilia : the official journal of the World Federation of Hemophilia.

[4]  T. Sculco,et al.  Orthopedic management of hemophilia. , 2005, American journal of orthopedics.

[5]  G. Young,et al.  Prophylactic recombinant factor VIIa in haemophilia patients with inhibitors , 2005, Haemophilia : the official journal of the World Federation of Hemophilia.

[6]  W. Mali,et al.  Successful treatment of severe bleeding in hemophilic target joints by selective angiographic embolization. , 2005, Blood.

[7]  D. Grobbee,et al.  The effects of postponing prophylactic treatment on long-term outcome in patients with severe hemophilia. , 2002, Blood.

[8]  J. Bijlsma,et al.  Iron deposits and catabolic properties of synovial tissue from patients with haemophilia. , 1998, The Journal of bone and joint surgery. British volume.

[9]  J. Lusher Prophylaxis in Children with Hemophilia: Is it the Optimal Treatment? , 1997, Thrombosis and Haemostasis.

[10]  J. Bijlsma,et al.  Cartilage damage as a result of hemarthrosis in a human in vitro model. , 1997, The Journal of rheumatology.

[11]  S. Gortmaker,et al.  Stress and incidence of bleeding in children and adolescents with hemophilia. , 1996, The Journal of pediatrics.

[12]  M. Hilgartner Hemophilic arthropathy. , 1974, Advances in pediatrics.