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BJA Advance Access published online on October 20, 2009
British Journal of Anaesthesia, doi:10.1093/bja/aep293
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© The Author [2009]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Recombinant activated factor VII for a patient with factor VII deficiency undergoing urgent intracerebral haematoma evacuation with underlying cavernous angioma

N. Liu1, S. Aldea2, D. François3, M. Cherqui-Michel1, M. Giansily-Blaizot4 and M. Fischler1,*

1 Department of Anaesthesiology,
2 Department of Neurosurgery and
3 Department of Biology, Hôpital Foch, 40 rue Worth, 92151 Suresnes, France.
4 Department of Hemostasis, CHU Montpellier, France

* Corresponding author. E-mail: m.fischler{at}hopital-foch.org

Inherited factor VII (FVII) deficiency is a rare autosomal-recessive bleeding disorder. There are no clear guidelines regarding therapy in such patients when intracerebral surgery is performed. We report the use of recombinant activated FVII (rFVIIa) for the prophylaxis of bleeding in a female with FVII deficiency (8% of activity) undergoing urgent removal of a right fronto-rolandic intracerebral haematoma secondary to a bleeding from a cavernous angioma. To assist haemostasis during and after surgery, rFVIIa boluses were administered during the procedure and continued every 12 h during 3 days after operation to maintain a prothrombin time <15 s. Using this approach, no abnormal bleeding or thromboembolic complications were observed and rFVIIa appeared safe in this context.

Keywords: blood, coagulation; complications, factor VII deficiency; neurosurgery, hemangioma, cavernous; recombinant FVIIa


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