TABLE 1.
Suggested prophylactic regiments for patients on FXI(a) inhibitors requiring surgery
| Low risk | Moderate risk | High risk |
|---|---|---|
| Observation or antifibrinolytic treatmenta,b | Antifibrinolytic treatmenta,b | Antifibrinolytic treatment and recombinant factor VIIaa,b |
| Cardiac catheterization | Oral and ENT surgery | Cardiac surgery |
| Cataract surgery | Periodontal surgery | Aortic aneurysm repair |
| PICC line placement | Transurethral prostatectomy | Pulmonary surgery |
| Fracture fixation | Lithotripsy | Mediastinoscopy |
| Carpal tunnel surgery | Tonsillectomy | Brain/CNS surgery |
| Endoscopy without biopsy | Rhinoplasty | Partial or total nephrectomy |
| Colonoscopy without biopsy | Tooth extraction | Colectomy |
| Skin biopsy | Lymph node biopsy | Total gastrectomy |
| Appendectomy | Pacemaker insertion | Pancreatectomy |
| Defibrillator insertion | Thyroidectomy | |
| Vagal nerve stimulation | Cystectomy | |
| Deep skin resection | Facelift | |
| Mastectomy | Radical prostatectomy | |
| Inguinal hernia repair | Laparoscopic cholecystectomy | |
| Ventral hernia repair | Major neck surgery | |
| Sleeve gastrectomy | ||
| Liposuction | ||
| Vitrectomy | ||
| Colonoscopy with biopsy | ||
| Hysterectomy with biopsy |
Abbreviations: CNS, central nervous system; ENT, ear-nose-throat; PICC, peripherally inserted central catheter.
a
In situations in which surgery involves tissues with high fibrinolytic activity, administration of antifibrinolytic drugs may be extended to 10 days.
b
Doses of antifibrinolytic drugs may need to be adjusted in patients with reduced renal function.