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Port-A-Cath usage in children with haemophilia: experience of 53 cases
R Ljung1, M van den Berg, P Petrini
1Department of Paediatrics, University Hospital, Malmö, Sweden.
Insights
The Port-A-Cath venous access system is safe and effective for children with hemophilia, enabling early home treatment. Complications are manageable, with most devices functioning without issues.
Area of Science:
- Pediatric Hematology
- Medical Devices
- Vascular Access
Background:
- Hemophilia A and B require long-term venous access for treatment.
- Implantable devices like Port-A-Cath offer a solution for chronic venous access needs.
- Managing hemophilia in children necessitates reliable and safe treatment delivery systems.
Purpose of the Study:
- To evaluate the safety and efficacy of the Port-A-Cath system in pediatric hemophilia patients.
- To assess complication rates and types associated with Port-A-Cath use in this population.
- To determine the suitability of Port-A-Cath for facilitating early home-based hemophilia treatment.
Main Methods:
- Retrospective review of Port-A-Cath implantable venous access system experience.
- Data collected from 53 children with severe or moderate hemophilia A or B across seven centers.
- Analysis of cumulative follow-up duration, complication types, and patient/physician feedback.
Main Results:
- 70% of Port-A-Cath devices (37/53) were used without complications over a median of 32 months.
- Complications occurred in 30% (16/53) of cases, primarily infections (56% of complications) and technical issues (44% of complications).
- 64% of patients with inhibitors experienced complications, yet overall device use was deemed acceptable.
Conclusions:
- The Port-A-Cath system demonstrates acceptable safety and efficacy for pediatric hemophilia patients.
- It facilitates early initiation of regular prophylactic or on-demand home treatment.
- Despite a notable complication rate, the benefits for managing hemophilia outweigh the risks.
Abstract:
Experience of the Port-A-Cath implantable venous access system in 53 children with severe or moderate haemophilia A or B from seven centres in five countries is reviewed. The cumulative duration of follow-up was 1578 months (median 30 months, range 1-114). Of the devices implanted, 70% (37/53) were used without complications (median follow-up 32 months; range 1-114) and the remaining 30% (16/53) were associated with various types of complication: infection, bacteraemia or septicaemia in 56% (9/16) of cases, i.e. a rate of 0.07 per follow-up year or 0.19 per 1000 patient days, or various technical complications occurring after a median of 32 months (range 4-75) of uncomplicated use in the remaining 44% (7/16). Of the patients with inhibitors, 64% (7/11) manifested complications. Both doctors and parents considered that the Port-A-Cath device can be used with an acceptable frequency and severity of complications, and that it enables regular prophylactic or on-demand home treatment of children with haemophilia to be begun at an early age.
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