Case control studies are interesting but cannot replace randomized controlled trials. As mentioned by the authors, the overall impact of rFVIIa on long-term outcomes such as mortality and limb salvage remains to be determined. rFVIIa is a potent hemostatic drug that has been associated with serious thromboembolic events. Its efficacy and safety in the context of vascular injuries will require further validation.
– Jean-Franois Hardy