Recombinant activated factor VII: a solution to refractory haemorrhage in vascular surgery? Export

@article{citeulike:3151712, abstract = {OBJECTIVES: Post-operative haemorrhage is a recognised complication and independent predictor of outcome in complex vascular surgery. The off-license administration of activated Recombinant Factor VII (rFVIIa) to treat haemorrhage in other surgical settings has been investigated, but concerns over potential adverse events have limited its use in vascular surgery. This article reports rFVIIa's method of action and systematically reviews rFVIIa's role in complex vascular surgery. METHODS: A systematic literature search identified articles reporting on rFVIIa administration within vascular surgery patients. Patient-specific data regarding transfusion requirements was extracted and pooled statistical analysis performed. RESULTS: 15 articles reporting 43 patients were identified. RFVIIa has been administered in open and endovascular procedures and in both elective and emergency settings. Major aortic surgery accounted for 75\% of cases. The range of rFVIIa administered as a cumulative dose was large, as was the variation in initial dose. Transfusion data from 9 patients was pooled and analysed. Significant differences were found between pre- and post- rFVIIa for packed red cell transfusions (mean 29.2 vs. 8.2, p=0.015). Intra-arterial thrombosis was reported in 3 cases. CONCLUSIONS: RFVIIa may reduce haemorrhage in selected vascular surgical patients. Randomized controlled trials are justified to definitively investigate its role within this setting.}, address = {Department of BioSurgery and Surgical Technology, Imperial College, London, United Kingdom. o.warren@imperial.ac.uk}, author = {Warren, O. J. and Alcock, E. M. and Choong, A. M. and Leff, D. R. and Van Herzeele, I. and Darzi, A. W. and Athanasiou, T. and Cheshire, N. J.}, citeulike-article-id = {3151712}, citeulike-linkout-0 = {http://dx.doi.org/10.1016/j.ejvs.2007.08.018}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/17964194}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=17964194}, doi = {10.1016/j.ejvs.2007.08.018}, issn = {1532-2165}, journal = {European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery}, keywords = {factor7, vascular}, month = {February}, number = {2}, pages = {145--152}, posted-at = {2008-08-24 01:32:28}, priority = {2}, title = {Recombinant activated factor VII: a solution to refractory haemorrhage in vascular surgery?}, url = {http://dx.doi.org/10.1016/j.ejvs.2007.08.018}, volume = {35}, year = {2008} }

TY - JOUR ID - citeulike:3151712 L3 - citeulike-article-id:3151712 N2 - OBJECTIVES: Post-operative haemorrhage is a recognised complication and independent predictor of outcome in complex vascular surgery. The off-license administration of activated Recombinant Factor VII (rFVIIa) to treat haemorrhage in other surgical settings has been investigated, but concerns over potential adverse events have limited its use in vascular surgery. This article reports rFVIIa's method of action and systematically reviews rFVIIa's role in complex vascular surgery. METHODS: A systematic literature search identified articles reporting on rFVIIa administration within vascular surgery patients. Patient-specific data regarding transfusion requirements was extracted and pooled statistical analysis performed. RESULTS: 15 articles reporting 43 patients were identified. RFVIIa has been administered in open and endovascular procedures and in both elective and emergency settings. Major aortic surgery accounted for 75% of cases. The range of rFVIIa administered as a cumulative dose was large, as was the variation in initial dose. Transfusion data from 9 patients was pooled and analysed. Significant differences were found between pre- and post- rFVIIa for packed red cell transfusions (mean 29.2 vs. 8.2, p=0.015). Intra-arterial thrombosis was reported in 3 cases. CONCLUSIONS: RFVIIa may reduce haemorrhage in selected vascular surgical patients. Randomized controlled trials are justified to definitively investigate its role within this setting. IS - 2 JF - European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery SN - 1532-2165 AD - Department of BioSurgery and Surgical Technology, Imperial College, London, United Kingdom. o.warren@imperial.ac.uk EP - 152 TI - Recombinant activated factor VII: a solution to refractory haemorrhage in vascular surgery? VL - 35 SP - 145 KW - factor7 KW - vascular AU - Warren, OJ AU - Alcock, EM AU - Choong, AM AU - Leff, DR AU - Van Herzeele, I AU - Darzi, AW AU - Athanasiou, T AU - Cheshire, NJ PY - 2008/02// UR - http://dx.doi.org/10.1016/j.ejvs.2007.08.018 ER -