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CardioVascular and Interventional Radiology

, Volume 36, Issue 4, pp 964–969 | Cite as

Hemophilic Chronic Synovitis: Therapy of Hemarthrosis using Endovascular Embolization of Knee and Elbow Arteries

  • E. GalliEmail author
  • A. Baques
  • N. Moretti
  • M. Candela
  • H. Caviglia
Clinical Investigation

Abstract

Purpose

Congenital hemophilia is a hereditary bleeding disorder that affects 1 in 5,000 males and is characterized by repetitive musculoskeletal bleeding episodes. Selective embolization of the knee and elbow arteries can prevent bleeding episodes. To evaluate the long-term efficacy of these procedures, we assessed the outcomes of 30 procedures performed in our center.

Methods

We performed 30 procedures in 27 hemophilic patients, including 23 knee, and 7 elbow procedures. To evaluate the efficacy of selective embolization of knee and elbow arteries in people with hemophilia, we analyzed the number of bleeding episodes during 12 months before the procedure compared with the amount of episodes that occurred 3, 6, and 12 months after embolization.

Results

Twenty-nine of 30 procedures were classified as successful. The median of 1.25 episodes per month (range 0–3) observed before the procedure was reduced to 0 (range 0–1.67; p < 0.001) at 3 months, 0.17 (range 0–1.67; p < 0.001) at 6 months, and 0.33 (range 0–1.67; p = 0.024) at 12 months. Three patients remained free of bleeding events for more than 6 months. Additionally, after the procedure there was a significant reduction in factor FVIII usage that sustained up to 12 months after the procedures. No serious adverse events were observed.

Conclusions

Selective angiographic embolization of knee and elbow arteries is a feasible procedure that can prevent repetitive bleedings, which would translate in better joint outcomes for these patients.

Keywords

Hemophilia Arterial embolization Hemarthrosis Interventional radiology 

Notes

Conflict of interest

None.

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Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2012

Authors and Affiliations

  • E. Galli
    • 1
    Email author
  • A. Baques
    • 2
    • 3
  • N. Moretti
    • 2
  • M. Candela
    • 2
    • 3
  • H. Caviglia
    • 1
    • 2
  1. 1.Hospital de Agudos “Juan A. Fernandez”CABABuenos AiresArgentina
  2. 2.Fundación de la Hemofilia de Buenos AiresCABABuenos AiresArgentina
  3. 3.Academia Nacional de MedicinaCABABuenos AiresArgentina

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