Journal
JOURNAL OF CLINICAL NEUROSCIENCE
Volume 17, Issue 6, Pages 685-693Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.jocn.2009.11.020
Keywords
Intracerebral hemorrhage; Randomized controlled trial; Recombinant activated factor VII; Meta-analysis; Thromboembolic adverse events
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Hematoma growth is common in intracerebral hemorrhage (ICH) and is associated with a poor outcome for patients. To evaluate the efficacy and safety of recombinant activated factor VII (rFVIIa) used as a hemostatic agent in patients with ICH without hemophilia, we searched Medline, Scopus, the Cochrane Library, Clinicaltrials.gov and the Stroke Trials Directory. Five randomized controlled trials were selected for analysis. Although rFVIIa can reduce the change in ICH volume, there was no significant difference in mortality, modified Rankin Scale (mRS) score or extended Glasgow Outcome Scale (GOS-E) score in patients treated with rFVIIa or placebo. There was a significant increase in arterial thromboembolic adverse events (TAE) in patients treated with rFVIIa. There was an increase in deep vein thrombosis in patients with spontaneous ICH and traumatic ICH. In conclusion, the use of rFVIIa reduces the growth of the hematoma but does not improve patient survival or functional outcome after ICH; in addition, rFVIIa increases the incidence of arterial TAE. (C) 2010 Elsevier Ltd. All rights reserved.
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