Postoperative pulmonary thromboembolism possibly associated with recombinant activated factor VII infusion for the treatment of uncontrolled hemorrhage during vertebral instrumentation.

We report the successful use of recombinant activated factor VII (rFVIIa) infusion in an 18-year-old man who underwent L3 laminectomy and pedicular screw fixation with severe refractory bleeding secondary to severe coagulopathy, which had remained unresponsive to conventional medical and surgical therapies. However, the patient developed a thromboembolic complication presumably associated with the use of rFVIIa. Although rFVIIa provides a dramatic response in intractable bleeding, it may cause a thromboembolic phenomenon which should be vigilantly considered and promptly treated.