{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T02:41:53Z","timestamp":1789180913937,"version":"build-2803163510"},"reference-count":105,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"abstract":"<jats:p>Factor XI inhibitors, including antisense oligonucleotides (ASOs), monoclonal antibodies (mAbs), and small-molecule inhibitors, are an emerging class of anticoagulants that offer the potential to prevent and treat thrombosis with a low risk of bleeding. As these agents move toward broader clinical use, it is essential to carefully review perioperative management due to their novel mechanisms and limited real-world experience. Data from clinical trials suggest a reassuring bleeding profile, even among high-risk groups such as patients with end-stage renal disease on hemodialysis and those on concurrent antiplatelet therapy. Many invasive procedures in patients receiving ASOs or mAbs have been reported, with few bleeding complications and little need for hemostatic prophylaxis or anticoagulant interruption. While small-molecule inhibitors may offer more flexibility due to their short half-lives, perioperative outcomes for these agents remain underreported. In emergencies, hemostasis may be achieved with factor XI concentrate for ASOs or bypassing agents for other factor XI inhibitors; however, these options may be limited by availability and potential thrombotic risks. Perioperative management strategies for factor XI inhibitors remain provisional and may require refinement as new evidence becomes available. Further research is needed to identify assays that better measure the anticoagulant effect of factor XI inhibitors, develop tailored protocols for both major and minor surgeries, and create specific reversal agents.<\/jats:p>","DOI":"10.1055\/a-2780-9033","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T23:53:30Z","timestamp":1767657210000},"source":"Crossref","is-referenced-by-count":2,"title":["Perioperative Management of Patients Receiving Factor XI Inhibitors"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9386-506X","authenticated-orcid":false,"given":"Carmen K. M.","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong"},{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Carlin","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada"},{"name":"Hamilton Health Sciences, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas C.","family":"Scheier","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond S. M.","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey I.","family":"Weitz","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Thrombosis and Atherosclerosis Research Institute and Hamilton Health Sciences, Hamilton, Ontario, Canada"},{"name":"Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Medical Sciences, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W.","family":"Eikelboom","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada"},{"name":"Hamilton Health Sciences, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James D.","family":"Douketis","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Hamilton Health Sciences, Hamilton, Ontario, Canada"},{"name":"Thrombosis and Atherosclerosis Research Institute and Hamilton Health Sciences, Hamilton, Ontario, Canada"},{"name":"Department of Medicine, St. Joseph's Healthcare Hamilton, and McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"e207","DOI":"10.1016\/j.chest.2022.07.025","article-title":"Perioperative management of antithrombotic therapy: an American College of Chest Physicians clinical practice guideline","volume":"162","author":"J D Douketis","year":"2022","journal-title":"Chest"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"a2200322","DOI":"10.1056\/EVIDra2200322","article-title":"Perioperative management of anticoagulant and antiplatelet therapy","volume":"2","author":"J D Douketis","year":"2023","journal-title":"NEJM Evid"},{"issue":"21","key":"ref3","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1056\/NEJM199705223362107","article-title":"Management of anticoagulation before and after elective surgery","volume":"336","author":"C Kearon","year":"1997","journal-title":"N Engl J Med"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s100169900214","article-title":"Warfarin anticoagulation in the perioperative period: is it safe?","volume":"13","author":"F J Caliendo","year":"1999","journal-title":"Ann Vasc Surg"},{"issue":"10","key":"ref5","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1001\/jama.2024.12708","article-title":"Perioperative management of patients taking direct oral anticoagulants: a review","volume":"332","author":"J D Douketis","year":"2024","journal-title":"JAMA"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1016\/j.chest.2022.11.032","article-title":"Perioperative management of vitamin K antagonists and direct oral anticoagulants: a systematic review and meta-analysis","volume":"163","author":"S Shah","year":"2023","journal-title":"Chest"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.jacc.2021.06.010","article-title":"Factor XI inhibition to uncouple thrombosis from hemostasis: JACC review topic of the week","volume":"78","author":"C Hsu","year":"2021","journal-title":"J Am Coll Cardiol"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1056\/NEJMoa1405760","article-title":"Factor XI antisense oligonucleotide for prevention of venous thrombosis","volume":"372","author":"H R B\u00fcller","year":"2015","journal-title":"N Engl J Med"},{"issue":"07","key":"ref9","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1056\/NEJMoa2105872","article-title":"Abelacimab for prevention of venous thromboembolism","volume":"385","author":"P Verhamme","year":"2021","journal-title":"N Engl J Med"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1001\/jama.2019.20687","article-title":"Effect of osocimab in preventing venous thromboembolism among patients undergoing knee arthroplasty: The FOXTROT randomized clinical trial","volume":"323","author":"J I Weitz","year":"2020","journal-title":"JAMA"},{"issue":"23","key":"ref11","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.1056\/NEJMoa2113194","article-title":"AXIOMATIC-TKR investigators. Milvexian for the prevention of venous thromboembolism","volume":"385","author":"J I Weitz","year":"2021","journal-title":"N Engl J Med"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.ekir.2021.11.011","article-title":"CS4 investigators. phase 2 study of the factor XI antisense inhibitor IONIS-FXIRx in patients with ESRD","volume":"7","author":"M Walsh","year":"2021","journal-title":"Kidney Int Rep"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.kint.2024.02.024","article-title":"A phase II randomized controlled trial evaluated antithrombotic treatment with fesomersen in patients with kidney failure on hemodialysis","volume":"106","author":"W C Winkelmayer","year":"2024","journal-title":"Kidney Int"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1038\/s41591-023-02794-7","article-title":"Anticoagulation with osocimab in patients with kidney failure undergoing hemodialysis: a randomized phase 2 trial","volume":"30","author":"J I Weitz","year":"2024","journal-title":"Nat Med"},{"issue":"22","key":"ref15","doi-asserted-by":"crossref","first-page":"2173","DOI":"10.1182\/blood.2021011725","article-title":"The contact activation inhibitor AB023 in heparin-free hemodialysis: results of a randomized phase 2 clinical trial","volume":"138","author":"C U Lorentz","year":"2021","journal-title":"Blood"},{"issue":"01","key":"ref16","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1161\/ATVBAHA.123.319692","article-title":"Factor XI inhibition for the prevention of catheter-associated thrombosis in patients with cancer undergoing central line placement: a phase 2 clinical trial","volume":"44","author":"M A Pfeffer","year":"2024","journal-title":"Arterioscler Thromb Vasc Biol"},{"issue":"04","key":"ref17","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1056\/NEJMoa2406674","article-title":"Abelacimab versus rivaroxaban in patients with atrial fibrillation","volume":"392","author":"C T Ruff","year":"2025","journal-title":"N Engl J Med"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1016\/S0140-6736(22)00456-1","article-title":"Safety of the oral factor XIa inhibitor asundexian compared with apixaban in patients with atrial fibrillation (PACIFIC-AF): a multicentre, randomised, double-blind, double-dummy, dose-finding phase 2 study","volume":"399","author":"J P Piccini","year":"2022","journal-title":"Lancet"},{"issue":"16","key":"ref19","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1161\/CIRCULATIONAHA.122.061612","article-title":"A multicenter, phase 2, randomized, placebo-controlled, double-blind, parallel-group, dose-finding trial of the oral factor XIa inhibitor asundexian to prevent adverse cardiovascular outcomes after acute myocardial infarction","volume":"146","author":"S V Rao","year":"2022","journal-title":"Circulation"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1016\/S0140-6736(22)01588-4","article-title":"Factor XIa inhibition with asundexian after acute non-cardioembolic ischaemic stroke (PACIFIC-Stroke): an international, randomised, double-blind, placebo-controlled, phase 2b trial","volume":"400","author":"A Shoamanesh","year":"2022","journal-title":"Lancet"},{"issue":"01","key":"ref21","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/S1474-4422(23)00403-9","article-title":"Safety and efficacy of factor XIa inhibition with milvexian for secondary stroke prevention (AXIOMATIC-SSP): a phase 2, international, randomised, double-blind, placebo-controlled, dose-finding trial","volume":"23","author":"M Sharma","year":"2024","journal-title":"Lancet Neurol"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1056\/NEJMoa2407105","article-title":"Asundexian versus apixaban in patients with atrial fibrillation","volume":"392","author":"J P Piccini","year":"2025","journal-title":"N Engl J Med"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.ahj.2024.08.011","article-title":"Milvexian vs apixaban for stroke prevention in atrial fibrillation: The LIBREXIA atrial fibrillation trial rationale and design","volume":"277","author":"S S Jain","year":"2024","journal-title":"Am Heart J"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.ahj.2025.02.011","article-title":"Oral factor XIa inhibitor milvexian after a recent acute coronary syndrome: rationale and design of the phase 3 (Librexia ACS)","volume":"285","author":"C M Gibson","year":"2025","journal-title":"Am Heart J"},{"issue":"10","key":"ref30","doi-asserted-by":"crossref","first-page":"295","DOI":"10.31083\/j.rcm2410295","article-title":"Abelacimab in cancer-associated thrombosis: The right drug at the right time for the right purpose. A comprehensive review","volume":"24","author":"A M Fioretti","year":"2023","journal-title":"Rev Cardiovasc Med"},{"issue":"23","key":"ref31","doi-asserted-by":"crossref","first-page":"2288","DOI":"10.1016\/j.jacc.2025.04.018","article-title":"Long-acting factor XI inhibition and periprocedural bleeding: an analysis from AZALEA-TIMI 71","volume":"85","author":"S M Patel","year":"2025","journal-title":"J Am Coll Cardiol"},{"issue":"22","key":"ref32","doi-asserted-by":"crossref","first-page":"4684","DOI":"10.1182\/blood-2010-04-277798","article-title":"Inhibition of the intrinsic coagulation pathway factor XI by antisense oligonucleotides: a novel antithrombotic strategy with lowered bleeding risk","volume":"116","author":"H Zhang","year":"2010","journal-title":"Blood"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1146\/annurev-med-041217-010829","article-title":"Therapeutic antisense oligonucleotides are coming of age","volume":"70","author":"C F Bennett","year":"2019","journal-title":"Annu Rev Med"},{"issue":"04","key":"ref34","doi-asserted-by":"crossref","first-page":"e13784","DOI":"10.1111\/cts.13784","article-title":"Pharmacokinetics, pharmacodynamics, and safety of fesomersen, a novel antisense inhibitor of factor XI, in healthy Chinese, Japanese, and Caucasian volunteers","volume":"17","author":"T Liu","year":"2024","journal-title":"Clin Transl Sci"},{"issue":"04","key":"ref35","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1111\/hae.12655","article-title":"Factor XI replacement for inherited factor XI deficiency in routine clinical practice: results of the HEMOLEVEN prospective 3-year postmarketing study","volume":"21","author":"F Bauduer","year":"2015","journal-title":"Haemophilia"},{"issue":"02","key":"ref36","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1111\/jth.15577","article-title":"Pharmacokinetics and pharmacodynamics of abelacimab (MAA868), a novel dual inhibitor of factor XI and factor XIa","volume":"20","author":"B A Yi","year":"2022","journal-title":"J Thromb Haemost"},{"issue":"02","key":"ref37","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1002\/rth2.12186","article-title":"BAY 1213790, a fully human IgG1 antibody targeting coagulation factor XIa: First evaluation of safety, pharmacodynamics, and pharmacokinetics","volume":"3","author":"D Thomas","year":"2019","journal-title":"Res Pract Thromb Haemost"},{"issue":"19","key":"ref38","doi-asserted-by":"crossref","first-page":"3981","DOI":"10.1182\/blood-2010-02-270918","article-title":"A role for factor XIIa-mediated factor XI activation in thrombus formation in vivo","volume":"116","author":"Q Cheng","year":"2010","journal-title":"Blood"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"100179","DOI":"10.1016\/j.crphar.2024.100179","article-title":"Abelacimab: a leap forward in anticoagulation with FXI and FXIa inhibition","volume":"6","author":"H A Badreldin","year":"2024","journal-title":"Curr Res Pharmacol Drug Discov"},{"issue":"05","key":"ref40","doi-asserted-by":"crossref","first-page":"e70012","DOI":"10.1002\/prp2.70012","article-title":"Pharmacokinetics and pharmacodynamics of the factor XIa-inhibiting antibody osocimab in healthy male East Asian volunteers: results from two phase 1 studies","volume":"12","author":"Z Dong","year":"2024","journal-title":"Pharmacol Res Perspect"},{"issue":"04","key":"ref41","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1161\/ATVBAHA.118.312328","article-title":"Contact activation inhibitor and factor XI antibody, AB023, produces safe, dose-dependent anticoagulation in a phase 1 first-in-human trial","volume":"39","author":"C U Lorentz","year":"2019","journal-title":"Arterioscler Thromb Vasc Biol"},{"issue":"01","key":"ref42","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1111\/jth.15579","article-title":"A proposal for managing bleeding in patients on therapeutic factor XI(a) inhibitors","volume":"20","author":"O Salomon","year":"2022","journal-title":"J Thromb Haemost"},{"issue":"08","key":"ref43","doi-asserted-by":"crossref","first-page":"102600","DOI":"10.1016\/j.rpth.2024.102600","article-title":"The anticoagulant effects of milvexian, a novel small molecule factor XIa inhibitor, are neutralized by activated prothrombin complex concentrates and recombinant factor VIIa in human plasma and whole blood in vitro","volume":"8","author":"M Bunce","year":"2024","journal-title":"Res Pract Thromb Haemost"},{"issue":"07","key":"ref45","doi-asserted-by":"crossref","first-page":"3447","DOI":"10.1111\/bcp.15230","article-title":"Pharmacokinetics, pharmacodynamics and safety of BAY 2433334, a novel activated factor XI inhibitor, in healthy volunteers: a randomized phase 1 multiple-dose study","volume":"88","author":"D Kubitza","year":"2022","journal-title":"Br J Clin Pharmacol"},{"issue":"02","key":"ref46","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1111\/cts.13148","article-title":"First-in-human study of milvexian, an oral, direct, small molecule factor XIa inhibitor","volume":"15","author":"V Perera","year":"2022","journal-title":"Clin Transl Sci"},{"issue":"11","key":"ref47","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1007\/s40262-024-01435-7","article-title":"Effect of age, sex, renal impairment and hepatic impairment on the safety, pharmacokinetics and pharmacodynamics of asundexian","volume":"63","author":"C Brase","year":"2024","journal-title":"Clin Pharmacokinet"},{"issue":"10","key":"ref48","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1007\/s40262-022-01150-1","article-title":"Single-dose pharmacokinetics of milvexian in participants with normal renal function and participants with moderate or severe renal impairment","volume":"61","author":"V Perera","year":"2022","journal-title":"Clin Pharmacokinet"},{"issue":"04","key":"ref49","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1111\/bcp.15981","article-title":"Pharmacokinetics of asundexian with combined CYP3A and P-gp inhibitors and an inducer: target in vitro and in vivo studies","volume":"90","author":"F Kanefendt","year":"2024","journal-title":"Br J Clin Pharmacol"},{"issue":"01","key":"ref50","doi-asserted-by":"crossref","first-page":"22239","DOI":"10.1038\/s41598-022-25936-2","article-title":"Effects of rifampin on the pharmacokinetics and pharmacodynamics of milvexian, a potent, selective, oral small molecule factor XIa inhibitor","volume":"12","author":"V Perera","year":"2022","journal-title":"Sci Rep"},{"issue":"11","key":"ref51","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1111\/jth.14598","article-title":"Scientific and Standardization Committee Communication: guidance document on the periprocedural management of patients on chronic oral anticoagulant therapy: recommendations for standardized reporting of procedural\/surgical bleed risk and patient-specific thromboembolic risk","volume":"17","author":"A C Spyropoulos","year":"2019","journal-title":"J Thromb Haemost"},{"issue":"05","key":"ref52","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1111\/j.1365-2516.2006.01304.x","article-title":"Variable bleeding manifestations characterize different types of surgery in patients with severe factor XI deficiency enabling parsimonious use of replacement therapy","volume":"12","author":"O Salomon","year":"2006","journal-title":"Haemophilia"},{"issue":"02","key":"ref53","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1097\/EJA.0000000000001600","article-title":"Regional anaesthesia in patients on antithrombotic drugs: Joint ESAIC\/ESRA guidelines","volume":"39","author":"S Kietaibl","year":"2022","journal-title":"Eur J Anaesthesiol"},{"issue":"10","key":"ref54","doi-asserted-by":"crossref","first-page":"2323","DOI":"10.1172\/JCI119412","article-title":"Thrombin-mediated activation of factor XI results in a thrombin-activatable fibrinolysis inhibitor-dependent inhibition of fibrinolysis","volume":"99","author":"P A Von dem Borne","year":"1997","journal-title":"J Clin Invest"},{"issue":"21","key":"ref55","doi-asserted-by":"crossref","first-page":"1986","DOI":"10.1056\/NEJMoa2201171","article-title":"Tranexamic acid in patients undergoing noncardiac surgery","volume":"386","author":"P J Devereaux","year":"2022","journal-title":"N Engl J Med"},{"issue":"03","key":"ref56","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1001\/jamasurg.2024.6048","article-title":"Safety and efficacy of tranexamic acid in general surgery","volume":"160","author":"L J Park","year":"2025","journal-title":"JAMA Surg"},{"issue":"09","key":"ref57","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1111\/anae.16058","article-title":"Prophylactic intravenous tranexamic acid and thromboembolism in non-cardiac surgery: a systematic review, meta-analysis and trial sequential analysis","volume":"78","author":"S EH Tsan","year":"2023","journal-title":"Anaesthesia"},{"issue":"04","key":"ref58","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1097\/00001721-199203040-00014","article-title":"Dental surgery in patients with severe factor XI deficiency without plasma replacement","volume":"3","author":"S Berliner","year":"1992","journal-title":"Blood Coagul Fibrinolysis"},{"issue":"05","key":"ref59","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1111\/hae.70052","article-title":"Recombinant activated factor VIIa combined with tranexamic acid control haemostasis in patients with severe factor XI deficiency undergoing urological procedures","volume":"31","author":"N Sternbach","year":"2025","journal-title":"Haemophilia"},{"issue":"03","key":"ref60","doi-asserted-by":"crossref","first-page":"102860","DOI":"10.1016\/j.rpth.2025.102860","article-title":"Management of bleeding and invasive procedures in patients treated with anti-factor XI(a) anticoagulants: proposals from the French Working Group on Perioperative Haemostasis and French Society of Thrombosis and Haemostasis","volume":"9","author":"A Godier","year":"2025","journal-title":"Res Pract Thromb Haemost"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1182\/asheducation-2009.1.97","article-title":"Factor XI deficiency\u2013resolving the enigma?","author":"P H Bolton-Maggs","year":"2009","journal-title":"Hematology (Am Soc Hematol Educ Program)"},{"issue":"01","key":"ref62","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.beha.2005.01.033","article-title":"Risks and side effects of therapy with plasma and plasma fractions","volume":"19","author":"S MacLennan","year":"2006","journal-title":"Best Pract Res Clin Haematol"},{"issue":"06","key":"ref63","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1016\/j.hoc.2021.07.012","article-title":"Factor XI deficiency","volume":"35","author":"M D Lewandowska","year":"2021","journal-title":"Hematol Oncol Clin North Am"},{"issue":"05","key":"ref64","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1111\/trf.12423","article-title":"Pathogen inactivation and removal methods for plasma-derived clotting factor concentrates","volume":"54","author":"R Klamroth","year":"2014","journal-title":"Transfusion"},{"issue":"04","key":"ref65","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1182\/blood.V84.4.1314.1314","article-title":"Activation of the coagulation cascade after infusion of a factor XI concentrate in congenitally deficient patients","volume":"84","author":"P M Mannucci","year":"1994","journal-title":"Blood"},{"issue":"04","key":"ref66","doi-asserted-by":"crossref","first-page":"e349","DOI":"10.1111\/hae.12457","article-title":"FXI concentrate use and risk of thrombosis","volume":"20","author":"P Bolton-Maggs","year":"2014","journal-title":"Haemophilia"},{"issue":"03","key":"ref67","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1111\/bjh.13058","article-title":"Guideline for the diagnosis and management of the rare coagulation disorders: a United Kingdom Haemophilia Centre Doctors' Organization guideline on behalf of the British Committee for Standards in Haematology","volume":"167","author":"A D Mumford","year":"2014","journal-title":"Br J Haematol"},{"issue":"05","key":"ref68","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1111\/j.1365-2516.2004.00944.x","article-title":"The rare coagulation disorders\u2013review with guidelines for management from the United Kingdom Haemophilia Centre Doctors' Organisation","volume":"10","author":"P H Bolton-Maggs","year":"2004","journal-title":"Haemophilia"},{"issue":"05","key":"ref69","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1111\/j.1365-2516.2011.02593.x","article-title":"Successful hip arthroplasty in an adult male with severe factor XI deficiency using hemoleven, a factor XI concentrate","volume":"17","author":"C Santoro","year":"2011","journal-title":"Haemophilia"},{"issue":"06","key":"ref70","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1111\/j.1365-2516.2011.02525.x","article-title":"The role of recombinant factor VIIa for obstetric block in women with severe factor XI deficiency","volume":"17","author":"S Setty","year":"2011","journal-title":"Haemophilia"},{"issue":"03","key":"ref71","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1160\/TH10-12-0816","article-title":"Monitoring low dose recombinant factor VIIa therapy in patients with severe factor XI deficiency undergoing surgery","volume":"106","author":"A Riddell","year":"2011","journal-title":"Thromb Haemost"},{"issue":"12","key":"ref72","doi-asserted-by":"crossref","first-page":"1927","DOI":"10.1055\/s-0039-1696685","article-title":"Single low dose of rFVIIa combined with antifibrinolytic agent is a simple and safe treatment for factor XI-deficient patients undergoing surgery","volume":"119","author":"O Salomon","year":"2019","journal-title":"Thromb Haemost"},{"issue":"04","key":"ref73","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1111\/j.1365-2516.2008.01663.x","article-title":"Recombinant factor VIIa to prevent surgical bleeding in factor XI deficiency","volume":"14","author":"N M O'Connell","year":"2008","journal-title":"Haemophilia"},{"issue":"03","key":"ref74","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1111\/j.1365-2516.2006.01276.x","article-title":"An illustrative case and a review on the dosing of recombinant factor VIIa in congenital factor XI deficiency","volume":"12","author":"S Schulman","year":"2006","journal-title":"Haemophilia"},{"issue":"05","key":"ref75","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1111\/j.1365-2516.2008.01780.x","article-title":"Use of recombinant factor VIIa for hip replacement surgery in a patient with severe factor XI deficiency and drug-induced platelet defect","volume":"14","author":"C E Dempfle","year":"2008","journal-title":"Haemophilia"},{"issue":"02","key":"ref76","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1055\/s-0035-1569068","article-title":"The judicious use of recombinant factor VIIa","volume":"42","author":"L T Goodnough","year":"2016","journal-title":"Semin Thromb Hemost"},{"issue":"01","key":"ref77","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1111\/j.1538-7836.2005.01683.x","article-title":"Prerequisites for recombinant factor VIIa-induced thrombin generation in plasmas deficient in factors VIII, IX or XI","volume":"4","author":"T Livnat","year":"2006","journal-title":"J Thromb Haemost"},{"issue":"12","key":"ref78","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1016\/j.jacc.2015.08.002","article-title":"Bridging anticoagulation: primum non nocere","volume":"66","author":"S J Rechenmacher","year":"2015","journal-title":"J Am Coll Cardiol"},{"issue":"05","key":"ref79","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1111\/j.1365-2516.2009.02043.x","article-title":"Lower doses of rFVIIa therapy are safe and effective for surgical interventions in patients with severe FXI deficiency and inhibitors","volume":"15","author":"G Kenet","year":"2009","journal-title":"Haemophilia"},{"issue":"03","key":"ref80","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1160\/TH09-03-0172","article-title":"Recombinant activated factor VII and tranexamic acid are haemostatically effective during major surgery in factor XI-deficient patients with inhibitor antibodies","volume":"102","author":"T Livnat","year":"2009","journal-title":"Thromb Haemost"},{"issue":"01","key":"ref81","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1111\/j.1365-2516.2005.01052.x","article-title":"Treatment of factor XI inhibitor using recombinant activated factor VIIa","volume":"11","author":"M M Bern","year":"2005","journal-title":"Haemophilia"},{"issue":"06","key":"ref82","first-page":"e512","article-title":"Management of severe factor XI deficiency in cardiac surgery: a case report and review of the literature","volume":"23","author":"N D Gay","year":"2017","journal-title":"Haemophilia"},{"issue":"05","key":"ref83","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1111\/hae.15081","article-title":"Diagnosis and management of factor XI alloinhibitors in patients with congenital factor XI deficiency-a large single-centre experience","volume":"30","author":"K S Kamel","year":"2024","journal-title":"Haemophilia"},{"issue":"06","key":"ref84","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1213\/00000539-199376060-00031","article-title":"Anesthetic management of a patient with factor XI deficiency and factor XI inhibitor undergoing a cesarean section","volume":"76","author":"N R Connelly","year":"1993","journal-title":"Anesth Analg"},{"issue":"04","key":"ref85","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1111\/j.1365-2141.1982.tb02830.x","article-title":"Life-threatening bleeding due to an acquired inhibitor to factor XII-XI successfully treated with 'activated' prothrombin complex concentrate (FEIBA)","volume":"51","author":"Z Rolovi\u0107","year":"1982","journal-title":"Br J Haematol"},{"issue":"02","key":"ref86","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.anclin.2017.01.005","article-title":"Anticoagulant reversal and anesthetic considerations","volume":"35","author":"J Meltzer","year":"2017","journal-title":"Anesthesiol Clin"},{"issue":"04","key":"ref87","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.tmrv.2021.06.007","article-title":"Roles of four-factor prothrombin complex concentrate in the management of critical bleeding","volume":"35","author":"K A Tanaka","year":"2021","journal-title":"Transfus Med Rev"},{"issue":"11","key":"ref88","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1001\/jamainternmed.2019.2431","article-title":"Perioperative management of patients with atrial fibrillation receiving a direct oral anticoagulant","volume":"179","author":"J D Douketis","year":"2019","journal-title":"JAMA Intern Med"},{"key":"ref89","volume-title":"Elimination half-life of drugs","author":"J Hallare","year":"2025"},{"issue":"01","key":"ref90","doi-asserted-by":"crossref","first-page":"5165","DOI":"10.1038\/s41598-022-08768-y","article-title":"Safety, pharmacokinetics, and pharmacodynamics of milvexian in healthy Japanese participants","volume":"12","author":"V Perera","year":"2022","journal-title":"Sci Rep"},{"issue":"12","key":"ref91","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1055\/a-2593-1763","article-title":"Factor XI inhibitors for myocardial infarction: a safer path to thrombotic protection?","volume":"125","author":"M Spagnolo","year":"2025","journal-title":"Thromb Haemost"},{"issue":"02","key":"ref92","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.jviscsurg.2014.01.009","article-title":"Peri-operative management of anticoagulation and antiplatelet therapy in gastrointestinal surgery","volume":"151","author":"S E Degirmenci","year":"2014","journal-title":"J Visc Surg"},{"issue":"09","key":"ref93","doi-asserted-by":"crossref","first-page":"2814","DOI":"10.1016\/j.ekir.2024.06.027","article-title":"Major bleeding rates in an international cohort of patients with end-stage kidney disease","volume":"9","author":"C R Coyle","year":"2024","journal-title":"Kidney Int Rep"},{"issue":"01","key":"ref94","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.ekir.2024.10.007","article-title":"A systematic review of safety and efficacy of factor XI\/XIa inhibitors in patients with ESKD on hemodialysis","volume":"10","author":"D Steiner","year":"2024","journal-title":"Kidney Int Rep"},{"key":"ref95","volume-title":"Managing Fresh-Frozen Plasma Transfusion Adverse Effects: Allergic Reactions, TACO, and TRALI","author":"M S Bharadwaj","year":"2025"},{"key":"ref96","volume-title":"Product monograph \u2013 CYKLOKAPRON (tranexamic acid): tablet, 500\u2009mg, oral and solution, 100\u2009mg\/mL, intravenous","author":"Pfizer Canada ULC"},{"key":"ref97","doi-asserted-by":"crossref","first-page":"62S","DOI":"10.1016\/S0735-1097(02)02776-6","article-title":"Oral anticoagulants in patients with coronary artery disease","volume":"41","author":"S S Anand","year":"2003","journal-title":"J Am Coll Cardiol"},{"issue":"03","key":"ref98","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1056\/NEJMoa065959","article-title":"Oral anticoagulant and antiplatelet therapy and peripheral arterial disease","volume":"357","author":"S Anand","year":"2007","journal-title":"N Engl J Med"},{"issue":"14","key":"ref99","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1056\/NEJMoa1709118","article-title":"Rivaroxaban with or without aspirin in stable cardiovascular disease","volume":"377","author":"J W Eikelboom","year":"2017","journal-title":"N Engl J Med"},{"issue":"05","key":"ref100","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1161\/CIRCULATIONAHA.125.074037","article-title":"Abelacimab versus rivaroxaban in patients with atrial fibrillation on antiplatelet therapy: a prespecified analysis of the AZALEA-TIMI 71 trial","volume":"152","author":"S Al Said","year":"2025","journal-title":"Circulation"},{"issue":"39","key":"ref101","doi-asserted-by":"crossref","first-page":"3826","DOI":"10.1093\/eurheartj\/ehac270","article-title":"2022 ESC guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery","volume":"43","author":"S Halvorsen","year":"2022","journal-title":"Eur Heart J"},{"issue":"01","key":"ref102","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.bpa.2009.09.009","article-title":"Perioperative coagulation monitoring","volume":"24","author":"S A Kozek-Langenecker","year":"2010","journal-title":"Best Pract Res Clin Anaesthesiol"},{"issue":"05","key":"ref103","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.1016\/j.jtha.2025.02.025","article-title":"Anticoagulant drugs targeting factor XI\/XIa and coagulation tests: we urgently need reliable pharmacodynamic data","volume":"23","author":"I Gouin-Thibault","year":"2025","journal-title":"J Thromb Haemost"},{"key":"ref104","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.thromres.2017.12.023","article-title":"Assessment of two contact activation reagents for the diagnosis of congenital factor XI deficiency","volume":"163","author":"S Salloum-Asfar","year":"2018","journal-title":"Thromb Res"},{"issue":"10","key":"ref105","doi-asserted-by":"crossref","first-page":"2401","DOI":"10.1182\/blood-2011-10-387134","article-title":"Antisense inhibition of coagulation factor XI prolongs APTT without increased bleeding risk in cynomolgus monkeys","volume":"119","author":"H S Younis","year":"2012","journal-title":"Blood"},{"key":"ref106","volume-title":"Factor XI assay","author":"The Pathology Centre"},{"issue":"01","key":"ref107","doi-asserted-by":"crossref","first-page":"242","DOI":"10.12998\/wjcc.v10.i1.242","article-title":"Intraoperative thromboelastography-guided transfusion in a patient with factor XI deficiency: a case report","volume":"10","author":"W J Guo","year":"2022","journal-title":"World J Clin Cases"},{"issue":"10","key":"ref108","first-page":"e72594","article-title":"Anesthetic implications of factor XI deficiency: a clinical case study and review of literature","volume":"16","author":"P R Martinez-Lopez","year":"2024","journal-title":"Cureus"},{"key":"ref109","doi-asserted-by":"crossref","first-page":"111566","DOI":"10.1016\/j.ijscr.2025.111566","article-title":"Optimizing the anesthetic management of factor XI deficiency in obstetrics: a case report using ROTEM","volume":"133","author":"A Ladib","year":"2025","journal-title":"Int J Surg Case Rep"},{"issue":"02","key":"ref111","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1182\/bloodadvances.2018024133","article-title":"Management of direct factor Xa inhibitor-related major bleeding with prothrombin complex concentrate: a meta-analysis","volume":"3","author":"S Piran","year":"2019","journal-title":"Blood Adv"},{"issue":"19","key":"ref112","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1056\/NEJMoa1006221","article-title":"Safety of recombinant activated factor VII in randomized clinical trials","volume":"363","author":"M Levi","year":"2010","journal-title":"N Engl J Med"}],"container-title":["Thrombosis and Haemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2780-9033.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:27:10Z","timestamp":1768436830000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2780-9033"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,5]]},"references-count":105,"URL":"https:\/\/doi.org\/10.1055\/a-2780-9033","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0340-6245","2567-689X"],"issn-type":[{"value":"0340-6245","type":"print"},{"value":"2567-689X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1,5]]},"published":{"date-parts":[[2026,1,5]]}}}