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Pulmonary embolism and fatal stroke in a patient with severe factor XI deficiency after bariatric surgery

Published in Blood Coagulation and Fibrinolysis. 2013, vol. 24, no. 3, p. 347-350
Abstract We report the case of a 40-year-old woman with a severe factor XI (FXI) deficiency who died from a stroke due to bilateral internal carotid arteries occlusion after a laparoscopic gastric bypass (bariatric surgery). This stroke was probably secondary to a pulmonary embolism with a paradoxical embolism through a previously unknown foramen ovale. This woman who had one severe episode of bleeding before the bypass received for the intervention a single infusion of 27 U/kg of FXI concentrate. A careful evaluation of the bleeding and thrombotic risk was performed before surgery, and despite all preventive measures, this tragic event occurred. The aim of this report is to alert medical teams to carefully balance the benefit-risk of such an intervention in a patient with a severe FXI deficiency.
Keywords AdultBariatric Surgery/adverse effectsCarotid Artery, Internal/pathologyCarotid Stenosis/etiology/pathologyEmbolism, Paradoxical/etiologyFactor XI Deficiency/complicationsFatal OutcomeFemaleForamen Ovale, Patent/complicationsGastric Bypass/adverse effectsHumansPulmonary Embolism/etiologyStroke/etiology
PMID: 23187784
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Research group Geneva Platelet Group (13)
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BOEHLEN, Françoise et al. Pulmonary embolism and fatal stroke in a patient with severe factor XI deficiency after bariatric surgery. In: Blood Coagulation and Fibrinolysis, 2013, vol. 24, n° 3, p. 347-350. doi: 10.1097/MBC.0b013e32835bdbec https://archive-ouverte.unige.ch/unige:85684

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Deposited on : 2016-08-05

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