Patients with a confirmed diagnosis of Acquired von Willebrand syndrome (AvWS) who are scheduled for minor surgery present a distinct perioperative hemostatic challenge. Impaired von Willebrand factor function in this setting raises the risk of surgical bleeding and requires a structured, protocol-driven approach from the outset.
Treatment ApproachManagement in this scenario involves a vWF/FVIII concentrate together with adjunctive antifibrinolytic therapy. The specific clinical indications, agent selection, sequencing, and all dosing criteria are defined in the full protocol — only a partial overview is presented here.
For patients undergoing minor surgery, desmopressin (DDAVP, 0.3 μg/kg i.v./s.c.) can be considered, with careful monitoring of vWF:Ag, FVIII:C, vWF:RCo/vWF:CB levels to guide repeat dosing due to its short effect duration.
vWF/FVIII concentrate if DDAVP inadequate.
Antifibrinolytic agents (e.g., tranexamic acid 20–25 mg/kg q8–12h) are recommended as adjunctive therapy, particularly in surgical sites with high fibrinolytic activity, such as oral or gastrointestinal mucosa.
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