Recombinant activated factor VII in the treatment of intractable non-surgical bleeding following major vascular procedures
INTRODUCTION A recombinant form of activated factor VII (rFVIIa) is a haemostatic drug that is approved for use in haemophiliacs with antibodies to factor VIII or factor IX. Most recent studies and clinical experience have shown that rFVIIa (NovoSeven ®, Novo Nordisk A/S, Denmark) gives extreme haem...
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| Format: | Article |
| Language: | English |
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Serbian Medical Society
2008-01-01
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| Series: | Srpski Arhiv za Celokupno Lekarstvo |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0370-8179/2008/0370-81790808367K.pdf |
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| author | Končar Igor B. Savić Nebojša Davidović Lazar B. Simić Dušica Marković Dejan Sinđelić Radomir B. |
| author_facet | Končar Igor B. Savić Nebojša Davidović Lazar B. Simić Dušica Marković Dejan Sinđelić Radomir B. |
| author_sort | Končar Igor B. |
| collection | DOAJ |
| description | INTRODUCTION A recombinant form of activated factor VII (rFVIIa) is a haemostatic drug that is approved for use in haemophiliacs with antibodies to factor VIII or factor IX. Most recent studies and clinical experience have shown that rFVIIa (NovoSeven ®, Novo Nordisk A/S, Denmark) gives extreme haemostatic effect in patients with severe "non-haemophilic" bleeding produced after trauma and major surgery. OBJECTIVE We present our preliminary experience of the use of rFVIIa in vascular surgery when conventional haemostatic measures are inadequate. METHOD There were 32 patients divided into five groups: Group I - 14 patients with ruptured abdominal aortic aneurysms; Group II - 10 patients with thoracoabdominal aortic aneurysms; Group III - 5 patients with retroperitoneal tumors involving great abdominal vessels; Group IV - 2 patients with portal hypertension and Group V - one patient with iatrogenic injury of brachial artery and vein during fibrinolytic treatment, because of myocardial infarction. RESULTS Clinical improvement was detected following treatment in 29 patients. Bleeding was successfully controlled as evidenced by improved haemodynamic parameters and decreased inotropic and transfusion requirements. CONCLUSION In vascular patients more liberal use of rFVIIa is limited, because no randomized controlled trial has proved its efficacy and safety in such patients; while also keeping in mind that the price of a 4.8 mg of rFVIIa is $4,080. We recommend the use of rFVIIa in vascular surgery only during and after operative treatment of thoracoabdominal aortic aneurysms, ruptured abdominal aortic aneurysms, retroperitoneal tumors involving the aorta and/or inferior vena cava, as well as portal hypertension, when non-surgical massive uncontrolled bleeding are present. |
| first_indexed | 2024-12-19T13:50:41Z |
| format | Article |
| id | doaj.art-b65fe289d33c41ffbd50180014c2aeb4 |
| institution | Directory Open Access Journal |
| issn | 0370-8179 |
| language | English |
| last_indexed | 2024-12-19T13:50:41Z |
| publishDate | 2008-01-01 |
| publisher | Serbian Medical Society |
| record_format | Article |
| series | Srpski Arhiv za Celokupno Lekarstvo |
| spelling | doaj.art-b65fe289d33c41ffbd50180014c2aeb42022-12-21T20:18:45ZengSerbian Medical SocietySrpski Arhiv za Celokupno Lekarstvo0370-81792008-01-011367-836737210.2298/SARH0808367KRecombinant activated factor VII in the treatment of intractable non-surgical bleeding following major vascular proceduresKončar Igor B.Savić NebojšaDavidović Lazar B.Simić DušicaMarković DejanSinđelić Radomir B.INTRODUCTION A recombinant form of activated factor VII (rFVIIa) is a haemostatic drug that is approved for use in haemophiliacs with antibodies to factor VIII or factor IX. Most recent studies and clinical experience have shown that rFVIIa (NovoSeven ®, Novo Nordisk A/S, Denmark) gives extreme haemostatic effect in patients with severe "non-haemophilic" bleeding produced after trauma and major surgery. OBJECTIVE We present our preliminary experience of the use of rFVIIa in vascular surgery when conventional haemostatic measures are inadequate. METHOD There were 32 patients divided into five groups: Group I - 14 patients with ruptured abdominal aortic aneurysms; Group II - 10 patients with thoracoabdominal aortic aneurysms; Group III - 5 patients with retroperitoneal tumors involving great abdominal vessels; Group IV - 2 patients with portal hypertension and Group V - one patient with iatrogenic injury of brachial artery and vein during fibrinolytic treatment, because of myocardial infarction. RESULTS Clinical improvement was detected following treatment in 29 patients. Bleeding was successfully controlled as evidenced by improved haemodynamic parameters and decreased inotropic and transfusion requirements. CONCLUSION In vascular patients more liberal use of rFVIIa is limited, because no randomized controlled trial has proved its efficacy and safety in such patients; while also keeping in mind that the price of a 4.8 mg of rFVIIa is $4,080. We recommend the use of rFVIIa in vascular surgery only during and after operative treatment of thoracoabdominal aortic aneurysms, ruptured abdominal aortic aneurysms, retroperitoneal tumors involving the aorta and/or inferior vena cava, as well as portal hypertension, when non-surgical massive uncontrolled bleeding are present.http://www.doiserbia.nb.rs/img/doi/0370-8179/2008/0370-81790808367K.pdfrecombinant activated factor VII (rFVIIa)intractablenon-surgical bleedingvascular surgery |
| spellingShingle | Končar Igor B. Savić Nebojša Davidović Lazar B. Simić Dušica Marković Dejan Sinđelić Radomir B. Recombinant activated factor VII in the treatment of intractable non-surgical bleeding following major vascular procedures Srpski Arhiv za Celokupno Lekarstvo recombinant activated factor VII (rFVIIa) intractablenon-surgical bleeding vascular surgery |
| title | Recombinant activated factor VII in the treatment of intractable non-surgical bleeding following major vascular procedures |
| title_full | Recombinant activated factor VII in the treatment of intractable non-surgical bleeding following major vascular procedures |
| title_fullStr | Recombinant activated factor VII in the treatment of intractable non-surgical bleeding following major vascular procedures |
| title_full_unstemmed | Recombinant activated factor VII in the treatment of intractable non-surgical bleeding following major vascular procedures |
| title_short | Recombinant activated factor VII in the treatment of intractable non-surgical bleeding following major vascular procedures |
| title_sort | recombinant activated factor vii in the treatment of intractable non surgical bleeding following major vascular procedures |
| topic | recombinant activated factor VII (rFVIIa) intractablenon-surgical bleeding vascular surgery |
| url | http://www.doiserbia.nb.rs/img/doi/0370-8179/2008/0370-81790808367K.pdf |
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