Percutaneous catheterization of the subclavian vein in hemophiliac patients: report of 47 cases.

Hemophiliac patients frequently require venous access, but usually their peripheral veins are collapsed and not puncturable. Several procedures employed to overcome this difficulty present a high complication rate. The authors report 47 cases of percutaneous subclavian vein catheterization (PSC) in hemophiliacs with an overall complication rate of 23%. Six patients (13%) had complications attributed to the coagulation disorder. The complications attributed to the coagulopathy and presenting major clinical importance occurred early in the series. After the improvement of the coagulation control with a routine AHG administration policy, the authors observed that among the last 22 patients there were 3 complications related to the coagulopathy, all of them without major clinical importance. The authors conclude that, in the lack of a safer access, PSC seems to be an acceptable procedure in hemophiliac patients, if employed with strict indication, accurate technique and rigorous control of the coagulopathhy.