PMID- 21215579
OWN - NLM
STAT- MEDLINE
DCOM- 20110527
LR  - 20161125
IS  - 1097-6809 (Electronic)
IS  - 0741-5214 (Linking)
VI  - 53
IP  - 4
DP  - 2011 Apr
TI  - Role of recombinant factor VIIa in the treatment of intractable bleeding in 
      vascular surgery.
PG  - 1032-7
LID - 10.1016/j.jvs.2010.07.075 [doi]
AB  - BACKGROUND: Most recent publications have shown that the recombinant form of 
      activated factor VII (rFVIIa; NovoSeven, Novo Nordisk A/S, Bagsvaerd, Denmark) 
      induces excellent hemostasis in patients with severe intractable bleeding caused 
      by trauma and major surgery. The purpose of this study was to determine the 
      influence of rFVIIa on the treatment of intractable perioperative bleeding in 
      vascular surgery when conventional hemostatic measures are inadequate. MATERIALS 
      AND METHODS: There were two groups of patients: the NovoSeven group (group N), 10 
      patients with ruptured abdominal aortic aneurysms (RAAAs) and 14 patients 
      operated on due to thoracoabdominal aortic aneurysms (TAAAs); the control group 
      (group C), 14 patients with RAAAs and 17 patients with TAAAs. All patients 
      suffered intractable hemorrhage refractory to conventional hemostatic measures, 
      while patients from group N were additionally treated with rFVIIa. RESULTS: 
      Postoperative blood loss was significantly lower in group N treated with rFVII (P 
      < .0001). Postoperative administration of packed red blood cells, fresh frozen 
      plasma, and platelets was lower in patients from group N, (P < .0001). Successful 
      hemorrhage arrest was reported in 21 patients (87.5%) treated with rFVIIa, and in 
      9 patients (29.03%) in group C (P < .001). Thirty-day mortality in these two 
      groups significantly differed. The mortality rate was 12.5% (3 patients) in group 
      N and 80.65% (25 patients) in group C (P < .0001). CONCLUSION: Our findings 
      suggest that rFVIIa may play a role in controlling the intractable perioperative 
      and postoperative bleeding in surgical patients undergoing a repair of RAAAs and 
      TAAAs. Certainly, prospective randomized trials are necessary to further confirm 
      the efficacy and cost-effectiveness of rFVIIa in these patients.
CI  - Copyright (c) 2011 Society for Vascular Surgery. Published by Mosby, Inc. All 
      rights reserved.
FAU - Koncar, Igor B
AU  - Koncar IB
AD  - Clinic for Vascular and Endovascular Surgery, Serbian Clinical Center, 8 K. 
      Todorovica St, Belgrade 11000, Republic of Serbia. dr.koncar@gmail.com
FAU - Davidovic, Lazar B
AU  - Davidovic LB
FAU - Savic, Nebojsa
AU  - Savic N
FAU - Sindelic, Radomir B
AU  - Sindelic RB
FAU - Ilic, Nikola
AU  - Ilic N
FAU - Dragas, Marko
AU  - Dragas M
FAU - Markovic, Miroslav
AU  - Markovic M
FAU - Kostic, Dusan
AU  - Kostic D
LA  - eng
PT  - Journal Article
DEP - 20110107
PL  - United States
TA  - J Vasc Surg
JT  - Journal of vascular surgery
JID - 8407742
RN  - 0 (Hemostatics)
RN  - 0 (Recombinant Proteins)
RN  - AC71R787OV (recombinant FVIIa)
RN  - EC 3.4.21.21 (Factor VIIa)
SB  - IM
CIN - J Vasc Surg. 2011 Apr;53(4):1037-8. PMID: 21439457
MH  - Aged
MH  - Analysis of Variance
MH  - Aortic Aneurysm, Abdominal/complications/mortality/*surgery
MH  - Aortic Aneurysm, Thoracic/mortality/*surgery
MH  - Aortic Rupture/etiology/mortality/*surgery
MH  - Blood Loss, Surgical/mortality/*prevention & control
MH  - Chi-Square Distribution
MH  - Erythrocyte Transfusion
MH  - Factor VIIa/*therapeutic use
MH  - Female
MH  - Hemostatics/*therapeutic use
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Platelet Transfusion
MH  - Postoperative Hemorrhage/etiology/mortality/*prevention & control
MH  - Prospective Studies
MH  - Recombinant Proteins/therapeutic use
MH  - Retrospective Studies
MH  - Serbia
MH  - Treatment Outcome
MH  - Vascular Surgical Procedures/*adverse effects/mortality
EDAT- 2011/01/11 06:00
MHDA- 2011/05/28 06:00
CRDT- 2011/01/11 06:00
PHST- 2009/10/02 00:00 [received]
PHST- 2010/05/05 00:00 [revised]
PHST- 2010/07/18 00:00 [accepted]
PHST- 2011/01/11 06:00 [entrez]
PHST- 2011/01/11 06:00 [pubmed]
PHST- 2011/05/28 06:00 [medline]
AID - S0741-5214(10)02450-X [pii]
AID - 10.1016/j.jvs.2010.07.075 [doi]
PST - ppublish
SO  - J Vasc Surg. 2011 Apr;53(4):1032-7. doi: 10.1016/j.jvs.2010.07.075. Epub 2011 Jan 
      7.