Neonatal Med.  2014 Aug;21(3):198-203.

Arterial Pseudoaneurysm in Neonates with Hemophilia: Successful Treatment with Noninvasive Clotting Factor Replacement and Ultrasound-guided Compression

• Kim BB
• Ju HY
• Park YS
• Bae CW

Abstract

Vascular cannulation is an invasive procedure that carries the risk of complications such as pseudoaneurysms. Hemophilia, the most common severe bleeding disorder of inheritance, increases the risk of such complications through underlying hypocoagulability. Although surgical ligation has been considered the gold standard treatment, less invasive options are currently available. Here we present 2 hemophiliac neonates for whom clotting factor replacement and ultrasound (US)-guided compression were successfully used. A 3-week-old male infant and a 4-week-old male infant presented with masses in the left antecubital area and the radial aspects of both wrists, respectively, after arterial punctures. The US confirmed the presence of pseudoaneurysms located at the left brachial artery and right radial artery. US-guided compressions with clotting factor administration initially attempted while confirming a thrombus inside the pseudoaneurysm sac indicated successful management. Arterial cannulation and other procedures in hemophiliac neonates must be attempted with caution because pseudoaneurysms or uncontrolled bleeding may occur. If laboratory analyses or invasive procedures are needed for neonates with a bleeding tendency or a suspected hemophiliac disorder, arterial or venous cannulation requires more caution or should be avoided if possible. This case report suggests that US-guided compression and clotting factor administration are suitable modalities for the treatment of small pseudoaneurysms in hemophilia patients.

Keyword

False aneurysm; Hemophilia A; Blood coagulation factor; Interventional ultrasonography

MeSH Terms

Aneurysm, False*
Blood Coagulation Factors
Brachial Artery
Catheterization
Hemophilia A*
Hemorrhage
Humans
Infant
Infant, Newborn*
Ligation
Male
Punctures
Radial Artery
Thrombosis
Ultrasonography
Ultrasonography, Interventional
Wills
Wrist
Blood Coagulation Factors