Factor VII and thromboembolism

Publication date: Available online 18 April 2018 Source:Trends in Anaesthesia and Critical Care Author(s): Ayten Saracoglu, Tiago Cardoso Recombinant activated factor VIIa (rFVIIa) is a potent haemostatic agent originally developed for the treatment of haemophilia patients with inhibitors against factor FVIII or FIX. In approved indications, the safety profile of rFVIIa is favourable without major concerns. The prevalence of thromboembolic (TE) complications is less than 4/100.000 with fatal events being extremely rare. Also, the majority of reported events occurred in elderly patients with predisposing factors for TE complications. Currently, off-label use of rFVIIa has become much more common with intracerebral haemorrhage and major surgical procedures being one of the most investigated areas. However, the literature had controversial results with a dubious safety profile. While in intracerebral haemorrhage and cardiac surgery the administration of rFVIIa appears to increase the risk for TE adverse events, in trauma patients, variceal bleeding and liver transplantation the risk doesn’t seem to be higher. Besides, no significant difference was reported in mortality rates. Moreover, a close monitoring for signs and symptoms of TE episodes is essential in patients treated with rFVIIa, especially the elderly and other patients with predisposing risk factors for thrombosis. In this opinion article, we aimed to review the current literature about the potential TE adverse ev...
Source: Trends in Anaesthesia and Critical Care - Category: Anesthesiology Source Type: research