Figure 3.
Considerations in developing personalized treatment plans for patients with BDUC. To develop a personalized treatment plan for a patient with BDUC, we first assess patient-related and procedure-related factors. A treatment plan for the specific procedure is then developed based on an ascending hierarchy of therapeutic options. In some patients with minimal objective evidence of previous bleeding, or in younger patients who have not undergone previous significant hemostatic challenges, with patient agreement we advocate an observation policy in the first instance. In these patients, TA and/or DDAVP are available on standby to manage any bleeding complications. For patients with previous procedure-related bleeding complications, we recommend TA alone or in combination with DDAVP before any significant future challenges. Platelet transfusions are used for patients with BDUC who develop bleeding complications despite therapy with TA and DDAVP. Finally, we only consider rFVIIa as a last-ditch option in patients with BDUC with ongoing active bleeding refractory to other treatment options. C/I, contraindication. All figures were created with BioRender.com.

Considerations in developing personalized treatment plans for patients with BDUC. To develop a personalized treatment plan for a patient with BDUC, we first assess patient-related and procedure-related factors. A treatment plan for the specific procedure is then developed based on an ascending hierarchy of therapeutic options. In some patients with minimal objective evidence of previous bleeding, or in younger patients who have not undergone previous significant hemostatic challenges, with patient agreement we advocate an observation policy in the first instance. In these patients, TA and/or DDAVP are available on standby to manage any bleeding complications. For patients with previous procedure-related bleeding complications, we recommend TA alone or in combination with DDAVP before any significant future challenges. Platelet transfusions are used for patients with BDUC who develop bleeding complications despite therapy with TA and DDAVP. Finally, we only consider rFVIIa as a last-ditch option in patients with BDUC with ongoing active bleeding refractory to other treatment options. C/I, contraindication. All figures were created with BioRender.com.

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