Coagulation factor Vila (recombinant) for warfarin-induced intracranial hemorrhage

摘要

Purpose. The use of coagulation factor Vlla (recombinant) for the treatment of warfarin-induced intracranial hemorrhage (ICH) is described.rnSummary. ICH Is a devastating disorder that can be exacerbated by the use of oral anticoagulation.The treatment of warfarin-associated ICH involves the prompt reversal of anticoagulation to allow for surgical procedures, if necessary. Despite limited labeled indications, factor Vlla (recombinant) has been used to reverse warfarin-induced anticoagulation in patients with active hemorrhage, partly due to the rapid effect of factor Vlla on the International Normalized Ratio and the ability to administer the drug quickly in acute settings. The efficacy of factor Vlla (recombinant) for the reversal of anticoagulation in patients with warfarin-associated ICH has been described in several case reports, case series, and retrospective cohort studies. Based on these reports, the use of factor Vlla (recombinant) for the treatment of warfarin-associated ICH may be a viable alternative or adjunct therapy to standard treatmentrnwith fresh-frozen plasma and vitamin K. However, due to the nature of these reports, future controlled trials should be conducted to verify the exact place for factor Vlla (recombinant) for this indication. Thromboembolic complications are rare but serious complications secondary to the use of factor Vlla (recombinant). Though differences exist in the reported rate of thromboembolic complications associated with factor Vlla (recombinant), factor Vlla (recombinant) should be used with caution in patients with a predisposition to thromboembolic complications. Conclusion. Use of factor Vlla (recombinant) may be considered for reversal of anticoagulation in patients with warfarin-associated ICH. However, patients should be screened for increased risk of thrombosis before administration of the drug.