Treatment for abdominal aortic aneurysm in a patient with hemophilia A: A case report and review of the literature

A 77-year-old man with abdominal aortic aneurysm (AAA) was referred to our department. His AAA, which was 6 cm in diameter, was found incidentally with ultrasonography. On admission the diagnosis of hemophilia A was made for the first time in his life because activated partial thromboplastin time was decreased to 32.3% and factor VIII coagulant activity was 2.1% (normal range 40% to 140%). Recombinant factor VIII supplemental therapy was continued during surgery to maintain his factor VIII level within the normal range. His AAA was operated successfully with bifurcated graft replacement. No unusual bleeding complications occurred during his hospitalization. With proper preparation the patient with AAA and hemophilia A can safely undergo surgical treatment. Three other cases of AAA with hemophilia in the English literature were reviewed, and this is the oldest patient with hemophilia who underwent AAA surgery.