Arteriovenous fistula as stable venous access in children with severe haemophilia

M. E. Mancuso, L. Berardinelli

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Treatment for children with severe haemophilia is based on prophylaxis and, if inhibitors occur, on immune tolerance induction (ITI). Both regimens require frequent infusions at early ages and therefore an adequate venous access is essential. Peripheral veins represent the best option; however, central venous catheters (CVCs) have been used to facilitate regular treatment. Unfortunately, survival of CVCs is affected by infectious and/or thrombotic complications that often lead to premature removal and consequent treatment discontinuation. This aspect may have an impact on treatment outcome, especially in the case of ITI. In light of this, internal arteriovenous fistula (AVF) has been proposed as an alternative option because of a lower rate of infectious complications. Moreover, AVF is easy to use in the home setting and is well accepted by children and parents. The possible complications are postoperative haematoma and transient symptoms of distal ischaemia; one case of symptomatic thrombosis has been reported to date. Other complications include loss of patency, aneurysmatic dilatation and limb dysmetria. A regular follow-up is mandatory to allow early remedial interventions. Surgical AVF dismantlement is recommended as soon as transition to peripheral vein access is possible.

Original languageEnglish
Pages (from-to)25-28
Number of pages4
JournalHaemophilia
Volume16
Issue numberSUPPL. 1
DOIs
Publication statusPublished - Jan 2010

Fingerprint

Arteriovenous Fistula
Hemophilia A
Immune Tolerance
Central Venous Catheters
Veins
Cerebellar Ataxia
Hematoma
Dilatation
Thrombosis
Therapeutics
Ischemia
Extremities
Parents
Survival

Keywords

  • Arteriovenous fistula
  • Haemophilia
  • Inhibitor
  • Prophylaxis
  • Venous access

ASJC Scopus subject areas

  • Hematology
  • Genetics(clinical)

Cite this

Arteriovenous fistula as stable venous access in children with severe haemophilia. / Mancuso, M. E.; Berardinelli, L.

In: Haemophilia, Vol. 16, No. SUPPL. 1, 01.2010, p. 25-28.

Research output: Contribution to journalArticle

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