Application of recombinant activated factor VII during surgery for a giant skull base hemangiopericytoma to achieve safe hemostasis. Case report.
The authors report on a 64-year-old woman with a huge recurrent skull base hemangiopericytoma, in whom they encountered severe difficulty in attaining intraoperative hemostasis. Standard surgical hemostatic methods and the administration of fresh-frozen plasma and prothrombin complex concentrates failed to stop diffuse bleeding from an inoperable tumor remnant. At a critical point during the operation, the intravenous administration of recombinant activated factor VII, combined with mechanical compression, finally led to satisfactory hemostasis. The rationale for using recombinant activated factor VII in situations of uncontrolled bleeding during neurosurgical procedures is discussed, along with the literature in which the use of recombinant activated factor VII as a maneuver of last resort is reported for hemostasis in other surgical fields.
Gerlach
Rüdiger
R
Department of Neurosurgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany. r.gerlach@em.uni-frankfurt.de
Marquardt
Gerhard
G
Wissing
Heimo
H
Scharrer
Inge
I
Raabe
Andreas
A
Seifert
Volker
V
D002533:Cerebral Angiography; D015942:Factor VIIa / Q000008:administration & dosage*; D005260:Female; D006393:Hemangiopericytoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D006487:Hemostasis / Q000187:drug effects; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage; D019292:Skull Base Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*
D011994:Recombinant Proteins; D015942:Factor VIIa