Journal of Thrombosis and Thrombolysis

, Volume 28, Issue 2, pp 215–219

Antithrombotic prophylaxis in patients with von Willebrand disease undergoing major surgery: when is it necessary?

  • Massimo Franchini
  • Giovanni Targher
  • Martina Montagnana
  • Giuseppe Lippi
Article

DOI: 10.1007/s11239-008-0253-7

Cite this article as:
Franchini, M., Targher, G., Montagnana, M. et al. J Thromb Thrombolysis (2009) 28: 215. doi:10.1007/s11239-008-0253-7

Abstract

Most patients with congenital von Willebrand disease (VWD) undergoing major surgical procedures require prophylactic replacement therapy with von Willebrand factor (VWF)/factor VIII (FVIII) concentrates. Venous thromboembolism has been reported in such patients, as a result of a combination of various treatments (i.e., type of surgery, progressive increase of post-infusion FVIII plasma levels) and/or patient-related thrombotic risk factors. On the whole, the literature data show that venous thromboembolic complications in surgical VWD patients who have been prophylactically treated with VWF/FVIII concentrates are extremely rare. Indeed, only 11 cases have been reported in the literature, mostly occurring during orthopedic procedures. Thus, in absence of a widely accepted consensus and adequate prospective studies, we advise that the need for thromboprophylaxis in such patients should be evaluated individually, after a careful risk/benefit analysis.

Keywords

Thromboprophylaxis von Willebrand disease Concentrates Surgery Venous thromboembolism Low-molecular-weight heparin 

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Massimo Franchini
    • 1
    • 2
  • Giovanni Targher
    • 3
  • Martina Montagnana
    • 4
  • Giuseppe Lippi
    • 4
  1. 1.Servizio di Immunoematologia e TrasfusioneAzienda Ospedaliero Universitaria di ParmaParmaItaly
  2. 2.Servizio di Immunoematologia e Trasfusione - Centro EmofiliaOspedale Policlinico, Piazzale Ludovico ScuroVeronaItaly
  3. 3.Sezione di Endocrinologia, Dipartimento di Scienze Biomediche e ChirurgicheUniversità di VeronaVeronaItaly
  4. 4.Istituto di Chimica e Microscopia Clinica, Dipartimento di Scienze Morfologico-BiomedicheUniversità di VeronaVeronaItaly

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