Endovascular abdominal aortic aneurysm repair in a patient with severe hemophilia B.

Purpose: To report a case of endovascular aneurysm repair (EVAR) in a patient with severe hemophilia B.

Case Report: A 63-year-old man with severe hemophilia B was referred for the treatment of a symptomatic infrarenal aortic aneurysm that had enlarged from 3.1 to 4.2 cm in diameter in the last 6 months. The patient was successfully treated with EVAR, associated with perioperative administration of titrated doses of high-purity factor IX concentrate. There were no perioperative complications, but a small type II endoleak was found on the initial postoperative computed tomographic scan; on the 6 month scan, the endoleak had not changed, and it is under intensive surveillance.

Conclusion: This case demonstrates that endovascular abdominal aortic repair is safe and feasible in severe hemophilic patients managed perioperatively with deficient coagulant protein replacement.