Successful carotid endarterectomy in a patient with factor XII deficiency (Hageman disease): a case report

Authors

DOI:

https://doi.org/10.14739/2310-1210.2025.4.324458

Keywords:

carotid endarterectomy, factor XII deficiency, Hageman disease, carotid stenosis, coagulopathy, case report

Abstract

Aim. To present the first documented case of successful carotid endarterectomy in a patient with severe Factor XII deficiency and analyze the features of perioperative management.

Materials and methods. We report a case of a 70-year-old male with critical left internal carotid artery stenosis (90 %) and incidentally discovered severe Factor XII deficiency (activity 0.1 %, activated partial thromboplastin time (aPTT) 235.0 seconds) during preoperative screening. A comprehensive differential diagnosis of prolonged aPTT was performed, including measurement of intrinsic coagulation factor activities and immunological testing. Classical carotid endarterectomy under local anesthesia was performed using a standard perioperative thromboprophylaxis protocol.

Results. The surgery and postoperative period were uneventful with a blood loss of 150 ml. Standard thromboprophylaxis was administered using unfractionated heparin intraoperatively and low molecular weight heparin postoperatively. At 3-month follow-up, ultrasound confirmed satisfactory reconstruction with normal flow parameters.

Conclusions. Isolated factor XII deficiency is not a contraindication for carotid endarterectomy when proper preoperative diagnosis is established, and standard perioperative protocols are followed. A multidisciplinary approach involving a hematologist is essential for successful management of such patients.

Author Biographies

M. O. Slabyi, Danylo Halytsky Lviv National Medical University

MD, Intern at the Department of Surgery, Plastic Surgery and Endoscopy, Faculty of Postgraduate Education

H. Yu. Orel, Danylo Halytsky Lviv National Medical University

MD, Vascular Surgeon, Assistant at the Department of Surgery No. 2

O. M. Slabyi, Danylo Halytsky Lviv National Medical University

MD, Vascular Surgeon, Assistant at the Department of Surgery No. 2

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Published

2025-08-31

How to Cite

1.
Slabyi MO, Orel HY, Slabyi OM. Successful carotid endarterectomy in a patient with factor XII deficiency (Hageman disease): a case report. Zaporozhye Medical Journal [Internet]. 2025Aug.31 [cited 2026May16];27(4):344-8. Available from: https://zmj.zsmu.edu.ua/article/view/324458

Issue

Vol. 27 No. 4 (2025)

Section

Case Reports

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Copyright (c) 2025 M. O. Slabyi, H. Yu. Orel, O. M. Slabyi

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