Implantable Intravenous Access Devices in Children With Hemophilia

A major component of modern therapy for patients with hemophilia is prompt administration of a factor VIII–or factor IX–containing concentrate at times of suspected or proven hemorrhage.¹ Immediate intravenous factor infusion is often hampered by difficulties with peripheral venous access. This is especially problematic in young patients whose veins are small and difficult to access and who may be uncooperative when their parents or medical personnel attempt to perform the venipuncture. Poor venous access may also prove troublesome in the older patient who desires home treatment but finds that self-infusion has become increasingly difficult. An implantable intravenous access device (IVAD), which is completely internal, can potentially solve these venous access problems. These devices have been widely used during the past decade in children with cancer.^2,3 However, little experience has yet been reported using this treatment strategy for patients with hemophilia.^4-6 Therefore, we retrospectively report our experience