Practical aspects of DDAVP use in patients with von Willebrand Disease undergoing invasive procedures: a European survey

Abstract

DDAVP can be recommended to cover invasive procedure in selected patients with VWD, however, we need more information and systematic recording of adverse events associated with DDAVP use in VWD. A companion paper will be published covering the use of factor concentrates in VWD patients.

Surgery in patients with von Willebrand disease

“…Recently, a literature survey on the management of vWD during surgical interventions and a survey of specialist hematologist centers across Europe, as per the national guidelines, was conducted by The European Haemophilia Therapy Strategy Board (EHTSB). This survey confirms the areas of agreement and areas of uncertainty seen in the literature, and the wide range of target levels of hemostatic factors that should be monitored to assess the efficacy of treatment [10]. In this study, factor concentrate and DDAVP were used on days 1, 2, and 3 following surgery in two type 1 patients who underwent circumcision.…”

Fifth Åland Island conference on von Willebrand disease

“…The main treatment options for the perioperative management of VWD patients are DDAVP and replacement factor concentrates. European Haemophilia Treatment Standardisation Board (EHTSB) recommendations for the practical use of DDAVP and factor concentrates in VWD patients undergoing invasive procedures have recently been published. The suitability of DDAVP should be determined by a test infusion in candidate patients .…”

“…European Haemophilia Treatment Standardisation Board (EHTSB) recommendations for the practical use of DDAVP and factor concentrates in VWD patients undergoing invasive procedures have recently been published. The suitability of DDAVP should be determined by a test infusion in candidate patients . DDAVP is ineffective in type 3 VWD, and its use in type 2B remains controversial due to the possibility of thrombocytopenia .…”

“…The suitability of DDAVP should be determined by a test infusion in candidate patients . DDAVP is ineffective in type 3 VWD, and its use in type 2B remains controversial due to the possibility of thrombocytopenia . It can, however, be used effectively to cover minor surgery and dental procedures in most other VWD patients, although factor concentrate is generally preferred for major surgery .…”

“…57 However, acquired or congenital coagulopathies may favour, if not directly cause, surgical haemorrhage in some cases. 57 Bleeding rates during surgery in patients with VWD have been shown to be high in the absence 58 60 DDAVP is ineffective in type 3 VWD, and its use in type 2B remains controversial due to the possibility of thrombocytopenia. 60 It can, however, be used effectively to cover minor surgery and dental procedures in most other VWD patients, although factor concentrate is generally preferred for major surgery.…”