Name of the Procedure:

Injection, Antihemophilic Factor VIII/Von Willebrand Factor Complex (Human), per Factor VIII I.U. (HCPCS Code: J7186)

• Common Names: Factor VIII Injection, Von Willebrand Factor Injection
• Medical Terms: Hemostatic Injection, Coagulation Factor Therapy

Summary

This procedure involves an injection of Factor VIII and Von Willebrand Factor complex, which helps promote blood clotting. It is used for patients with certain bleeding disorders to prevent or treat bleeding episodes.

Purpose

The injection is used to:

• Manage hemophilia A, a condition where blood doesn't clot properly due to a lack of Factor VIII.
• Treat von Willebrand disease, where there's a deficiency or defect in Von Willebrand factor.
• Control bleeding during surgical procedures or after injuries in affected individuals.

Indications

• Patients with diagnosed hemophilia A or von Willebrand disease.
• Individuals experiencing a bleeding episode or those scheduled for surgery.
• Patients needing routine prophylaxis to reduce the risk of bleeding.

Preparation

• No specific fasting required.
• Review of medical history and current medications.
• Blood tests to determine the current levels of clotting factors.

Procedure Description

1. The skin at the injection site is cleaned.
2. The prescribed dose of Factor VIII/Von Willebrand Factor complex is prepared.
3. The injection is administered intravenously.
4. Vital signs are monitored throughout the injection process.
5. The patient is observed for any immediate adverse reactions.

Tools/Equipment:

• Syringe, sterile needles, alcohol swabs, and the Factor VIII/Von Willebrand Factor complex solution.

Anesthesia:

• No anesthesia or sedation typically required.

Duration

The injection process usually takes about 15-30 minutes.

Setting

The procedure can be performed in various settings:

• Hospital
• Outpatient clinic
• Specialty infusion centers

Personnel

• Physician or hematologist
• Registered nurse or trained medical professional

Risks and Complications

Common Risks:

• Mild reactions at the injection site, such as redness or swelling.

Rare Risks:

• Allergic reactions, which can range from mild itching to severe anaphylaxis.
• Development of inhibitors (antibodies) towards Factor VIII, reducing its effectiveness.

Benefits

• Immediate reduction or cessation of bleeding.
• Decreased risk of bleeding complications during surgery.
• Improved quality of life by preventing spontaneous bleeding episodes.

Recovery

Post-Procedure Care:

• Monitoring in the healthcare setting for a brief period after the injection.
• Instruction on signs of complications to watch for.

Recovery Time:

• Immediate ability to resume normal activities after observation.
• No significant restrictions but avoid strenuous activities on the day of administration.

Alternatives

• Desmopressin (DDAVP) for milder cases.
• Cryoprecipitate or plasma for emergency treatment.
• Gene therapy (experimental).

Pros and Cons:

• Desmopressin is less invasive but less effective for severe cases.
• Cryoprecipitate is effective in emergencies but carries a higher risk of bloodborne infections.

Patient Experience

During the Procedure:

• Potential mild discomfort at the injection site.

After the Procedure:

• Typically, minimal discomfort.
• General comfort measures include rest and hydration.

Pain Management:

• Over-the-counter analgesics (if needed).
• Reassurance and supportive care from healthcare providers.