A 27-Year-Old Man Is Referred for Preoperative Evaluation Prior to Elective

A 27-year-old man is referred for preoperative evaluation prior to elective craniotomy to remove a benign brain tumor.  He was diagnosed with type 1 von Willebrand disease at age 17 and has intermittent epistaxis and easy bruising.  Last year he had a prolonged and severe episode of epistaxis that required cautery and nasal packing.  He has no other medical problems or surgeries.  The patient has no known drug allergies.
Vital signs are within normal limits.  Skin examination shows an area of ecchymosis on the left thigh.  Neurologic examination is normal.
Laboratory results are as follows:
The patient has blood type A, and von Willebrand factor (VWF) antigen and activity level are pending.
Which of the following is the most effective strategy for decreasing this patient's risk of perioperative bleeding?

A) Aminocaproic acid
B) Cryoprecipitate
C) Desmopressin
D) Platelet transfusions
E) VWF preparations

Correct Answer:

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