Hemostatic effect of DDAVP on tooth extraction in patients with mild and moderate hemophilia A and von Willebrand disease

The hemostatic effect of 1-deamino-8-D-arginine vasopressin (DDAVP) on tooth extraction was investigated in 7 patients with mild and moderate hemophilia A and von Willebrand disease. Tooth extraction was performed uneventfully on 10 occasions under DDAVP treatment. Primary hemostasis was completely achieved, and postoperative bleeding was not noted in any case. Four activities (VIII: C, VIEW: Ag, VIII R: Ag, VIII R: RC) of F VIII/vWF increased several times 30-60 minutes after DDAVP injection and remained high for 1-3 hours and returned to the initial levels after 24 hours. The increase was high enough to control the hemostasis in most cases, although the cases of hemophilia A showing low VIII: C and von Willebrand Type II A showing low VIII R: RC had a poorer response. These results indicate that DDAVP is useful for the control of hemostasis after tooth extraction in patients with hemophilia A and von Willebrand disease.