Safety of Prohemostatic Interventions

Abstract

Pharmacological prohemostatic agents may be useful adjunctive treatment options in patients with severe blood loss. The efficacy of these interventions has been established in a variety of clinical situations. However, the procoagulant effect of these interventions may tip the balance toward a higher risk of thrombotic complications. Several studies have shown that some prohemostatic interventions may indeed increase the risk of arterial and venous thromboembolism, although these complications are relatively rare. When considering the use of adjunctive prohemostatic agents to prevent or treat excessive blood loss, the risk of thrombotic complications should be taken into account.

Bleeding risk of surgery and its prevention in patients with inherited platelet disorders

“…Finally, pro-hemostatic agents, and in particular recombinant FVIIa, may predispose to thrombotic complications; however, the latter are relatively rare and depend on the thrombotic risk profile of the patient and the procedure. 5 , 35 …”

Adverse Effects of Drugs on Hemostasis and Thrombosis

“…To some extent, the adverse prothrombotic effects of prohemostatic therapy aimed to correct bleeding or the adverse bleeding risk of agents aimed to prevent thrombosis occurrence, including the new oral anticoagulants dabigatran and rivaroxaban, can be viewed as anticipated risks under certain conditions, and this has perhaps been well illustrated by recent reports in Seminars in Thrombosis & Hemostasis. [1][2][3] The current issue of Seminars in Thrombosis & Hemostasis will provide the reader with a much broader review of drugassociated risks factors for thrombosis and bleeding, a subject that is otherwise infrequently described in the literature. The first article by Maxwell and Bennett 4 reviews the importance of venous thromboembolism prophylaxis for cancer patients, with a focus on the ambulatory care setting.…”