Prostatic artery embolization in men with severe hemophilia a: a case report of two patients

Abstract

Background This is the first case report describing the peri- and postoperative hemostasis plans in two men with severe hemophilia A (HA) who underwent prostatic artery embolization (PAE) for symptomatic benign prostatic hyperplasia (BPH). Case presentation Two patients with severe HA and lower urinary tract symptoms (LUTS) not responding to medical therapy underwent PAE at our institution. In both patients, intermittent administration of decreasing doses of extended half-life recombinant factor VIII (EHL rFVIII) concentrate from 30 min before to 7 days after the PAE resulted in good hemostatic control. In addition to EHL rFVIII, tranexamic acid was administered in the same timeframe to augment the action of EHL rFVIII and to account for possible mucosal bleeding from the urinary tract. Both patients reported a minor localized hematoma at the femoral puncture site in the right groin, that resolved spontaneously. No other bleeding complications were observed. Conclusions The procoagulant effects of the chosen dosing of EHL rFVIII showed sufficient to perform a technically successful embolization. At 6 months follow-up, both patients had significant reduction in self-reported urinary symptoms and were content with the outcome.

Partial Splenic Embolization in a Patient with Hemophilia A and Severe Thrombocytopenia: A Case Report

“…Patients with hemophilia in the era of inadequate factor VIII replacement therapy have problems with hemarthrosis, and vascular embolization of the joints in these patients has been frequently reported. As shown in Table 2 , effective and minimally invasive treatments for patients with hemophilia also include vascular embolization for acute bleeding (spontaneous, postoperative, and traumatic), preoperative embolization for pseudotumors, and the efficacy of prostatic artery embolization for enlarged prostate [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ].…”