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Settings in which factor XI replacement may be reserved for serious bleeding rather than given prophylactically

Settings in which factor XI replacement therapy may be reserved for serious bleeding rather than administered before the procedure

Minor surgical procedures

Cataract surgery
Dental extractions*
Circumcision* (delay until age six months if possible)
Orthopedic surgery*
Appendectomy
Cholecystectomy

Menorrhagia*

Vaginal delivery* (if known to tolerate bleeding challenges without severe bleeding)

Factor XI replacement therapy can be done using a factor XI concentrate (not available in the United States) or a plasma product such as Fresh Frozen Plasma (FFP). This table provides a suggested approach for individuals with factor XI deficiency, but it does not take the place of the judgment of the treating clinician who is familiar with the patient's bleeding phenotype and values and preferences. Refer to UpToDate for details.

FXI: factor XI.
* In these circumstances, it is often appropriate to use an antifibrinolytic agent such as tranexamic acid (TXA) or epsilon aminocaproic acid (EACA). These can be given orally or intravenously. Refer to UpToDate for details of dosing and administration.

Graphic 119190 Version 1.0