Periprocedural prophylactic therapeutic options in minor and major surgeries of patients with FXI deficiency
| Therapy . | Type of intervention . | |
|---|---|---|
| Minor surgery . | Major surgery . | |
| Antifibrinolytic agents82 | 3-5 days: | 7-10 days: |
| Tranexamic acid | 10-20 mg/kg per dose, 3 times daily (up to maximal dose of 1300 mg, 3 times a day) | 10-20 mg/kg per dose, 3 times daily |
| Aminocaproic acid | 50-100 mg/kg, 4 times a day (up to maximal dose of 5 g) | 50-100 mg/kg, 4 times a day (up to 5 g) |
| Fresh frozen plasma82 | No | 15-20 mL/kg, repeat every 24-48 hours, as required |
| Pd-FXI concentrate75 (Hemoleven, LFB) (BPL FXI) | No | 10-20 U/kg per dose, repeat every 48-72 hours, as needed |
| rFVIIa61 NovoSeven (off-label use) | No | 10-15 μg/kg per dose, a single dose is usually sufficient |
| Therapy . | Type of intervention . | |
|---|---|---|
| Minor surgery . | Major surgery . | |
| Antifibrinolytic agents82 | 3-5 days: | 7-10 days: |
| Tranexamic acid | 10-20 mg/kg per dose, 3 times daily (up to maximal dose of 1300 mg, 3 times a day) | 10-20 mg/kg per dose, 3 times daily |
| Aminocaproic acid | 50-100 mg/kg, 4 times a day (up to maximal dose of 5 g) | 50-100 mg/kg, 4 times a day (up to 5 g) |
| Fresh frozen plasma82 | No | 15-20 mL/kg, repeat every 24-48 hours, as required |
| Pd-FXI concentrate75 (Hemoleven, LFB) (BPL FXI) | No | 10-20 U/kg per dose, repeat every 48-72 hours, as needed |
| rFVIIa61 NovoSeven (off-label use) | No | 10-15 μg/kg per dose, a single dose is usually sufficient |
In sites of increased fibrinolysis, a longer duration of antifibrinolytic treatment is suggested, even in cases of minor surgery. Caution is advised in coadministration of antifibrinolytic agents with FXI concentrates because of potential thrombotic complications.
BPL, British Physical Laboratories; LFB, Laboratoire français du Fractionnement et des Biotechnologies; Pd, plasma derived; rFVIIa, recombinant activated factor VII.