Hemophilia A pseudoaneurysm in a patient with high responding inhibitors complicating total knee arthroplasty: embolization: a cost-reducing alternative to medical therapy

Kickuth, Ralph; Anderson, Suzanne; Peter-Salonen, Kristiina; Lämmle, Bernhard; Eggli, Stefan; Triller, Jürgen (2006). Hemophilia A pseudoaneurysm in a patient with high responding inhibitors complicating total knee arthroplasty: embolization: a cost-reducing alternative to medical therapy. Cardiovascular and interventional radiology, 29(6), pp. 1132-5. New York, N.Y.: Springer-Verlag; www.springer-ny.com 10.1007/s00270-005-0371-y

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Joint hemorrhages are very common in patients with severe hemophilia. Inhibitors in patients with hemophilia are allo-antibodies that neutralize the activity of the clotting factor. After total knee replacement, rare intra-articular bleeding complications might occur that do not respond to clotting factor replacement. We report a 40-year-old male with severe hemophilia A and high responding inhibitors presenting with recurrent knee joint hemorrhage after bilateral knee prosthetic surgery despite adequate clotting factor treatment. There were two episodes of marked postoperative hemarthrosis requiring extensive use of substitution therapy. Eleven days postoperatively, there was further hemorrhage into the right knee. Digital subtraction angiography diagnosed a complicating pseudoaneurysm of the inferior lateral geniculate artery and embolization was successfully performed. Because clotting factor replacement therapy has proved to be excessively expensive and prolonged, especially in patients with inhibitors, we recommend the use of cost-effective early angiographic embolization.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Kickuth, Ralph; Lämmle, Bernhard; Eggli, Stefan and Triller, Kurt-Jürgen

ISSN:

0174-1551

ISBN:

16933159

Publisher:

Springer-Verlag; www.springer-ny.com

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:46

Last Modified:

24 Oct 2019 08:48

Publisher DOI:

10.1007/s00270-005-0371-y

PubMed ID:

16933159

Web of Science ID:

000241606000037

BORIS DOI:

10.7892/boris.19237

URI:

https://boris.unibe.ch/id/eprint/19237 (FactScience: 1721)

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