Korean Journal of Pediatrics 2008;51(12):1359-1362.
Published online December 15, 2008.
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
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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