85230 Clotting; factor VII (proconvertin, stable factor)

Name of the Procedure:

Clotting; Factor VII (Proconvertin, Stable Factor)

Summary

Clotting factor VII replacement therapy involves administering factor VII, a protein that helps the blood to clot. This procedure is used to treat bleeding episodes or prevent bleeding in patients with factor VII deficiency.

Purpose

The primary aim of clotting factor VII replacement therapy is to treat or prevent bleeding in individuals with a deficiency of factor VII. It helps stabilize the patient’s clotting process, reducing the risk of uncontrolled bleeding.

Indications

• Patients diagnosed with factor VII deficiency
• Individuals experiencing spontaneous bleeding episodes
• Pre-surgical patients with known factor VII deficiency to prevent bleeding complications

Preparation

• Patients may need to undergo blood tests to assess clotting levels.
• No specific fasting or medication adjustments are typically required unless specified by the healthcare provider.
• The healthcare provider will review the patient’s medical history and current medications.

Procedure Description

1. Pre-Procedure Assessment: Blood samples are taken to measure current factor VII levels.
2. Preparation of Factor VII Concentrate: The prescribed dose of factor VII concentrate is prepared.
3. Administration: The factor VII concentrate is administered intravenously. The infusion may take a few minutes to an hour depending on the dose and patient needs.
4. Monitoring: Vital signs and clotting levels are monitored during and after administration to ensure the desired effect.

Tools, Equipment, or Technology Used:

• Intravenous (IV) catheter and drip setup
• Factor VII concentrate (recombinant or plasma-derived)
• Blood pressure monitor and other vital sign monitoring devices

Anesthesia or Sedation Details:

Typically, no anesthesia or sedation is required as it is a non-invasive procedure.

Duration

The procedure itself, including the infusion of clotting factor VII, generally takes between 15 minutes to an hour.

Setting

The procedure is usually performed in a hospital, outpatient clinic, or specialized infusion center.

Personnel

• Hematologist or specialized physician
• Registered nurse or infusion specialist
• Laboratory technician for blood sample analysis

Risks and Complications

• Common Risks: Mild allergic reactions, slight pain or bruising at the injection site.
• Rare Risks: Severe allergic reactions (anaphylaxis), development of inhibitors (antibodies) against factor VII, thrombosis (blood clots in other areas).

Benefits

• Immediate reduction or cessation of bleeding episodes.
• Prevention of bleeding complications during surgical procedures.
• Improved quality of life by managing bleeding risks effectively.

Recovery

• Patients are typically observed for a short duration post-infusion to monitor for any adverse reactions.
• Most can resume normal activities immediately, but strenuous activities should be avoided for 24 hours.
• Follow-up appointments may be scheduled to monitor clotting levels and overall health.

Alternatives

• Fresh frozen plasma infusion (provides multiple clotting factors but less specific than factor VII concentrate).
• Antifibrinolytic medications (e.g., tranexamic acid).
• Gene therapy (still experimental for factor VII deficiency).

Pros and Cons of Alternatives:

• Fresh Frozen Plasma: Less specific, higher volume may be required, increased risk of allergic reactions.
• Antifibrinolytic Medications: Useful for mild cases, but not suitable for severe deficiencies.
• Gene Therapy: Promising but currently experimental and not widely available.

Patient Experience

• During the Procedure: Patients may feel a slight prick from the IV insertion but should experience minimal discomfort during the infusion.
• After the Procedure: Some may feel mild fatigue but can generally carry on with their routine, avoiding strenuous activities for a short period. Pain management typically isn't required, though over-the-counter pain relief can be used if necessary.