What is your preferred treatment agent for type 1 von Willebrand patients needing minor procedures if they have a history of severe hyponatremia with DDAVP?

I would avoid DDAVP. I typically individualize hemostatic management based on the procedure- related risk of bleeding and severity of the VWD. For example, for dental extraction, tranexamic acid alone may suffice; however, communication with the proceduralist to use topical agents such as topical th...

I appreciate Dr. @Dr. First Last answer with regard to comparing the relative risk of bleeding to the risk of the therapy.

An alternative approach to avoiding this helpful therapy is to point out that hyponatremia isn't possible with desmopressin if the patient doesn't get excess free water. As an e...

I agree with Dr. @Dr. First Last, that the party line is to avoid DDAVP, but in select cases, especially with strict fluid restriction per Dr. @Dr. First Last comment, we have used half-dose DDAVP, though our published experience is relatively small, and have not seen pronounced hyponatremia. On the...

Depends on the procedure. Could you potentially try just an antifibrinolytic? Is the risk of bleeding high enough that you feel you need to provide some coverage, in which case, you could give a single dose of factor replacement, or even consider factor replacement "on hold" in case of bleeding, and...