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Blood, 1 April 2005, Vol. 105, No. 7, pp. 2654-2657. Prepublished online as a Blood First Edition Paper on December 21, 2004; DOI 10.1182/blood-2004-06-2063. This Article Full Text (PDF) All Versions of this Article: 2004-06-2063v1 105/7/2654    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Mauser-Bunschoten, E. P Articles by Roosendaal, G. Search for Related Content PubMed PubMed Citation Articles by Mauser-Bunschoten, E. P Articles by Roosendaal, G. Related Collections Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted June 2, 2004 Accepted September 28, 2004 Successful treatment of severe bleeding in hemophilic target joints by selective angiographic embolization Eveline P Mauser-Bunschoten*, Jacco A Zijl, Willem Mali, A C van Rinsum, H M van den Berg, and Goris Roosendaal Van Creveldkliniek, Department of Internal Medicine, University Medical Center Utrecht, Utrecht, The Netherlands Department of Orthopedic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands Department of Radiodiagnostics, University Medical Center Utrecht, Utrecht, The Netherlands * Corresponding author; email: E.Mauserbunschoten{at}azu.nl. Bleeding into the joints is common in hemophilia. After total knee or elbow replacement, profuse intra-articular bleeding unresponsive to high dose clotting factor replacement some times occurs. In some patients who have severely damaged elbow or knee joints the same profuse bleeding pattern can be seen. To control bleeding in these patients selective catherization with a microcatheter and therapeutic embolization with microcoils was performed whenever a severe blush or micro-aneurysm was observed on angiography. Over 12 years, in 23 cases of massive joint bleeding in 18 patients with hemophilia selective catherization was performed. In 15 cases the bleeding was post-operative, and in 8 spontaneous. Results of angiographic imaging revealed vascular blush, false aneurysm, true aneurysm and arterio-venous shunt in combination with an aneurysm as cause of bleeding. In two patients the cause of bleeding was not found. In 21 cases an embolization procedure was performed, in which the bleeding was completely controlled by a single procedure in 14 cases. Recurrence of the bleeding occurred in 7 cases requiring a second embolization procedure, in one patient even a third embolization was required to stop the bleeding completely. No difference in the outcome, i.e. clinical end of bleeding and joint range of motion, was observed, when comparing post-operative and spontaneous bleeding. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Plug the hole Louis M. Aledort Blood 2005 105: 2621. [Full Text] [PDF] This article has been cited by other articles: U. Sadat, J. Naik, and P. D. Hayes Surgical Complications in a Hemophilia Patient With Factor VIII Inhibitor and Their Endovascular Management Vascular and Endovascular Surgery, May 1, 2008; 42(2): 168 - 172. [Abstract] [PDF]

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