Preemptive use of recombinant activated factor VII: many questions but few answers.

摘要

Recombinant activated factor VII (rVIIa) is a prohemostatic agent, which was developed for patients with congenital or acquired hemophilia and inhibiting antibodies toward factors VIII or IX. It acts locally at the site of tissue injury and vascular wall disruption, where it binds to exposed tissue factor, giving rise to small amounts of thrombin that activate platelets. It then interacts directly or indirectly with the platelet surface, amplifying coagulation and generating a thrombin burst. Recombinant activated factor VII thus plays a major role in hemostasis resulting in platelet activation, and in the final conversion of fibrinogen into fibrin. In addition rVIIa interferes with fibrinolysis when activating the thrombin-activatable fibrinolysis inhibitor and, as a result, stabilizes the fibrin clot.