{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T17:43:51Z","timestamp":1787593431863,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:00:00Z","timestamp":1664150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Emicizumab treatment may allow patients with hemophilia A without (PwHA) and with inhibitors (PwHA\u2010I) to undergo some minor surgeries, such as tooth extraction, without peri\u2010operative factor infusions. However, criteria for determining the necessity of factor infusions before minor surgeries are unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>We report the peri\u2010operative hemostatic management and outcomes of emicizumab\u2010treated PwHA and PwHA\u2010I cases who underwent tooth extractions using our institutional protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively evaluated PwHA and PwHA\u2010I who underwent tooth extraction with emicizumab prophylaxis at our institution. Local bleeding risk was assessed based on the method, number, and site of tooth extraction. Hemostasis was monitored peri\u2010operatively by rotational thromboelastometry (ROTEM). Hemostatic agents and a mouth splint were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010nine extractions (17 interventions) were performed in eight PwHA and two PwHA\u2010I. Based on ROTEM, pre\u2010operative factor infusions were used in ten PwHA and four PwHA\u2010I interventions. Among nine low local bleeding risk interventions, three (33.3%) each received no infusions, one dose of factor infusion pre\u2010operatively, and pre\u2010 and post\u2010operative factor infusions. All eight high local bleeding risk interventions involved planned factor infusions. Absorbable hemostats were used in all extractions. A mouth splint was used in 21\/25 (84.0%) PwHA and in 4\/4 (100%) PwHA\u2010I extractions. No post\u2010extraction bleeding or thrombotic events occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Use of a systemic hemostatic treatment plan according to the local bleeding risk, peri\u2010operative coagulation status assessment using ROTEM, filling the extraction socket with hemostats, and use of a mouth splint can achieve effective and safe hemostatic management in emicizumab\u2010treated PwHA and PwHA\u2010I.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hae.14667","type":"journal-article","created":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T00:19:55Z","timestamp":1664237995000},"page":"172-179","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Peri\u2010operative hemostatic management of tooth extraction in patients with hemophilia A, with and without inhibitors, receiving emicizumab prophylaxis"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3490-2371","authenticated-orcid":false,"given":"Takahiro","family":"Yagyuu","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Nara Medical University  Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4786-8945","authenticated-orcid":false,"given":"Shoko","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Nara Medical University  Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miki","family":"Zaizen","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Nara Medical University  Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachiko","family":"Yata","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Nara Medical University  Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhiko","family":"Imada","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Nara Medical University  Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2415-2194","authenticated-orcid":false,"given":"Keiji","family":"Nogami","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Nara Medical University  Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadaaki","family":"Kirita","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Nara Medical University  Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,26]]},"reference":[{"issue":"1","key":"e_1_2_11_2_1","first-page":"S10","article-title":"The burden of inhibitors in haemophilia patients","volume":"116","author":"Walsh CE","year":"2014","journal-title":"Thromb Haemost"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-021-03095-w"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13877"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1511769"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-08-801662"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm.2942"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16574"},{"issue":"1","key":"e_1_2_11_9_1","first-page":"163","article-title":"Mode of enhancement in the global haemostatic potentials with concomitant use of bypassing agents and emicizumab in haemophilia A patients with inhibitor evaluated by ROTEM","volume":"1","author":"Yada K","year":"2017","journal-title":"Res Pract Thromb Haemost"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14022"},{"issue":"1","key":"e_1_2_11_11_1","first-page":"115","article-title":"Surgical experience from four phase III studies (HAVEN 1\u20134) of emicizumab in persons with haemophilia A (PwHA) with or without FVIII inhibitors","volume":"3","author":"Santagostino E","year":"2019","journal-title":"Res Pract Thromb 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hemorrhage after extraction of third molars:case report and management protocol","volume":"68","author":"Moghadam HG","year":"2002","journal-title":"J Can Dent 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