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Case Report

Open Access

Recombinant factor Vlla therapy in a patient on long term anticoagulant treatment with a bleeding and acute subdural hematoma

  • NATAŠA KOVAÈ1
  • ALEKSANDAR GOPÈEVIÆ1
  • JOSIP KOVAÈ1
  • PETAR GAÆINA 2
  • MLADEN NOVKOSKI1

1Department of Anesthesiology, University Hospital “Sestre milosrdnice”

2Department of Hemathology, University Hospital “Sestre milosrdnice”

DOI: 10.22514/SV22.102007.7 Vol.2,Issue 2,October 2007 pp.25-26

Published: 20 October 2007

*Corresponding Author(s): NATAŠA KOVAÈ E-mail: nkovac@inet.hr

Abstract

In this paper we report on the successful correction of a coagulopathy with activated recombinant factor seven (rFVIIa) therapy which enabled surgical removal of a life threatening subdural hematoma. The severe coagulopathy developed due to long term warfarin therapy, which followed heart valvular reconstruction and replacement. The coagulopathy failed to improve following fresh frozen plasma and vitamin K therapy. Activated recombinant factor VII therapy became the treatment of choice, which enabled the life saving surgical removal of the subdural hematoma.

Keywords

activated recombinant factor seven, subdural hematoma, anticoagulant therapy, neurosurgery

Cite and Share

NATAŠA KOVAÈ,ALEKSANDAR GOPÈEVIÆ,JOSIP KOVAÈ,PETAR GAÆINA ,MLADEN NOVKOSKI. Recombinant factor Vlla therapy in a patient on long term anticoagulant treatment with a bleeding and acute subdural hematoma. Signa Vitae. 2007. 2(2);25-26.

References

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2. Abu-Hajir M, Hollowell J, Nagaroje G: Managment of 2 patients with subdural hematoma and coagulopathy with recombinant human activated Factor VII . Blood, 98:79b (11 Part 2), 2001 (Abstract)

3. Al Douri M, Shafi T, Al Khudairi D, et al: Effect of the administration of recombinant activated factor VII (rVIIa; NovoSeven (R) ) in the management of severe uncontrolled bleeding in patients undergoing heart valve replacement surgery. Blood Coagulation and Fibrinolysis 11 (Suppl 1):S121-S127, 2000

4. Bernstein ED, Jeffers L, Erhardtsen E, et al: Recombinant factor VIIa corrects prothrombin time in cirrhotic patients: A preliminary study: Gastroenterology 113:1930-1937, 1997

5. Billion S, Le Niger C, Escoffre-Barbe M, et al: The use of recombinant factor VIIa (NovoSeven (R)) in a patient with a factor XI deficiency and circulating anticoagulant. Blood Coagulation and Fibrinolysis 12 :551-553, 2001

6. Deveras RAE, Kessler CM: Recombinant factor VIIa (rFVIIa) successfully and rapidly corrects the excessively high international normalized ratios (INR) and prothrombin times induced by warfarin. Blood 96 (11 Part 1): 638a, 2000

7. Deveras RA, Kessler CM: Reversal of Warfarin-Induced Excessive Anticoagulation with Recombinant Human Factor VIIa Concentrate. Ann Inter Med. 137:884-888, 2002

8. Hender U: Recombinant factor VIIa (NovoSeven) as a hemostatic agent. Semin Hematol 38 (4 Suppl 12):43-47, 2001

9. Hendriks GDH, Van der Maaten JMAA, De Wolf J, et al: An Effective Treatment of Severe Intractable Bleeding After Valve Repair by One Single Dose of Activated Recombinant Factor VII. Anesth analg 93:287-289, 2001

10. Kessler C: Hemorrhagic complication of thrombocytopenia and oral anticoagulant: Is there a role for recombinant activated factor VII ?. Intensive Care Med 28 (Suppl 2):S228, 2002

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