Publication Date:
2018-11-29
Description:
Recent international consensus guidelines recommend that patients with significant bleeding phenotypes and plasma VWF levels in the 30-50 IU/dL range should be classified as Low von Willebrand factor (Low VWF). Critically however, evidence-based guidelines regarding optimal clinical management strategies for this cohort have not been defined. In particular, data regarding the need for hemostatic cover for procedures in Low VWF are limited. To address this deficit, as part of the Low Von Willebrand in Ireland Cohort (LoVIC) study we conducted a systematic retrospective review of all procedures in a large cohort of well characterised patients with Low VWF. Methods: Following written informed consent, we collated data on all procedures performed in LoVIC patients over a 17 year period (1/1/00-12/31/17). Case notes were reviewed and data collected in a standard proforma - age at intervention, choice of hemostatic cover, perioperative VWF, haemoglobin (Hgb) levels and reported bleeding. Procedures were categorised as dental extractions (DE), minor (e.g. endoscopies, joint injections) or major surgery. Tranexamic acid (TA) was prescribed 1g TDS. All desmopressin (DDAVP) was administered intravenously (IV, 0.3mg/kg). Results: 165 procedures in 65 LoVIC participants were identified. The procedural group was significantly older (median 45 vs 38.8 years, p
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine