Additionally, TFPI is also involved in the regulation of coagulation26 and previously, plasma TFPI correlated with several hemostatic factors and with AAA diameter in preoperative patients.27 Previous authors have described a decrease in thrombin activation months after EVAR, compared to the preoperative state, but the relationship with sac size has not yet been investigated.28 Our results might indicate endothelial activation or a decrease in thrombin activation proportional to the sac size, months to years after EVAR. This evidence concerns the gene TFPI and triple-A syndrome.