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Tail Vein Transection Bleeding Model in Fully Anesthetized Hemophilia A Mice
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Published on: September 30, 2021

Perioperative Outcomes in Factor XI Deficiency: A Systematic Review.

Zainab Al-Housni1, Raeesah Mohammed2, Silvio Ligia1

  • 1Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Haemophilia : the Official Journal of the World Federation of Hemophilia
|May 26, 2026
PubMed
Summary
This summary is machine-generated.

Factor XI (FXI) deficiency bleeding risk is unpredictable with FXI activity alone. A comprehensive approach considering surgical factors and patient history is needed for better perioperative management in FXI-deficient patients.

Keywords:
antifibrinolytic agentsfactor XI deficiencyfresh frozen plasmaperioperative caresurgical bleedingsystematic review

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Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
13:08

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Published on: September 9, 2012

Area of Science:

  • Hematology
  • Surgical Management
  • Clinical Review

Background:

  • Congenital factor XI (FXI) deficiency presents a variable bleeding phenotype.
  • Current management strategies for FXI deficiency are heterogeneous, lacking robust evidence.
  • Existing data primarily comes from case reports and small retrospective studies.

Purpose of the Study:

  • To systematically review perioperative bleeding outcomes in patients with factor XI deficiency.
  • To evaluate current management strategies for factor XI deficiency during surgical procedures.

Main Methods:

  • Systematic literature search across five databases (2016-2024).
  • Independent screening and data extraction by two reviewers.
  • Qualitative synthesis of cohort data and descriptive summary of case reports.
  • Development of an exploratory framework to analyze bleeding patterns.

Main Results:

  • Included 21 studies (4 cohorts, 17 case reports) covering over 590 procedures.
  • Cohort bleeding rates varied (0-19%), with major bleeding ≤ 7%.
  • FXI activity did not consistently correlate with bleeding; procedural factors and bleeding history were more predictive.
  • Case reports, often involving severe FXI deficiency, showed infrequent bleeding with FFP-based prophylaxis and antifibrinolytics.

Conclusions:

  • Factor XI activity alone is insufficient for predicting perioperative bleeding risk.
  • A multifactorial approach integrating surgical risk and hemostatic strategy is recommended.
  • Further research is necessary to optimize preoperative management for FXI-deficient patients.