Extraction in a patient with Type 3 von Willebrand disease: A case of effective hemostasis after administration of Vonicog Alfa

Tooth extraction in patients with von Willebrand disease (VWD) is difficult because of the associated bleeding. Current treatment involves the use of plasma-derived von Willebrand factor (VWF), and recombinant VWF has recently been developed. This report describes a case of tooth extraction in which hemostasis was successfully achieved with the use of recombinant VWF. The patient was an older male who presented to our department for a tooth extraction. His medical history included uncontrolled bleeding after sinus surgery and factor VIII deficiency. After investigation, a diagnosis of type 3 VWD was made. On the day of admission, recombinant VWF was administered, and the mandibular left first molar was extracted under local anesthesia the next day. The patient was treated with recombinant VWF until the fifth day. The patient had no postoperative bleeding. This outcome suggests that recombinant VWF is effective for tooth extraction in VWD patients.