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Percutaneous coronary intervention and the management of acute coronary syndromes in patients with von Willebrand disease.
J Invasive Cardiol. 2013 Apr; 25(4):E81-6.JI

Abstract

BACKGROUND

Von Willebrand disease (vWD) results from quantitative or qualitative deficiency of von Willebrand factor (vWF). The occurrence of myocardial infarction is very rare in patients with vWD. A few case reports of acute coronary syndrome (ACS) in vWD patients are present in the literature, but no definite management recommendations are available for such patients.

CASE REPORT

We report a case of successful percutaneous coronary intervention (PCI) with bare-metal stent (BMS) implantation in a 46-year-old woman with type 1 vWD and history of coronary artery disease (CAD). She received periprocedural dual-antiplatelet therapy for 2 weeks and then continued aspirin without any bleeding complications.

MANAGEMENT PROPOSAL

The optimal management of patients with vWD and ACS is complex and presents a therapeutic challenge. We propose that dual-antiplatelet therapy can be used safely in most vWD patients presenting with ACS as most of them are type 1 vWD. PCI with BMS can be done safely. Long-term management of these patients requires a systemic approach including hematological consultation, ascertaining vWF levels, as well as patient education and close outpatient follow-up.

Authors+Show Affiliations

Cardiology Section, Virginia-Tech Carilion School of Medicine and Research Instituite, Roanoke, Virginia, USA. srathore@carilionclinic.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

23549503

Citation

Rathore, Sulaiman, et al. "Percutaneous Coronary Intervention and the Management of Acute Coronary Syndromes in Patients With Von Willebrand Disease." The Journal of Invasive Cardiology, vol. 25, no. 4, 2013, pp. E81-6.
Rathore S, Deleon D, Akram H, et al. Percutaneous coronary intervention and the management of acute coronary syndromes in patients with von Willebrand disease. J Invasive Cardiol. 2013;25(4):E81-6.
Rathore, S., Deleon, D., Akram, H., Sane, D., & Ball, T. (2013). Percutaneous coronary intervention and the management of acute coronary syndromes in patients with von Willebrand disease. The Journal of Invasive Cardiology, 25(4), E81-6.
Rathore S, et al. Percutaneous Coronary Intervention and the Management of Acute Coronary Syndromes in Patients With Von Willebrand Disease. J Invasive Cardiol. 2013;25(4):E81-6. PubMed PMID: 23549503.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Percutaneous coronary intervention and the management of acute coronary syndromes in patients with von Willebrand disease. AU - Rathore,Sulaiman, AU - Deleon,Dexter, AU - Akram,Hafsa, AU - Sane,David, AU - Ball,Timothy, PY - 2013/4/4/entrez PY - 2013/4/4/pubmed PY - 2014/1/3/medline SP - E81 EP - 6 JF - The Journal of invasive cardiology JO - J Invasive Cardiol VL - 25 IS - 4 N2 - BACKGROUND: Von Willebrand disease (vWD) results from quantitative or qualitative deficiency of von Willebrand factor (vWF). The occurrence of myocardial infarction is very rare in patients with vWD. A few case reports of acute coronary syndrome (ACS) in vWD patients are present in the literature, but no definite management recommendations are available for such patients. CASE REPORT: We report a case of successful percutaneous coronary intervention (PCI) with bare-metal stent (BMS) implantation in a 46-year-old woman with type 1 vWD and history of coronary artery disease (CAD). She received periprocedural dual-antiplatelet therapy for 2 weeks and then continued aspirin without any bleeding complications. MANAGEMENT PROPOSAL: The optimal management of patients with vWD and ACS is complex and presents a therapeutic challenge. We propose that dual-antiplatelet therapy can be used safely in most vWD patients presenting with ACS as most of them are type 1 vWD. PCI with BMS can be done safely. Long-term management of these patients requires a systemic approach including hematological consultation, ascertaining vWF levels, as well as patient education and close outpatient follow-up. SN - 1557-2501 UR - https://www.unboundmedicine.com/medline/citation/23549503/Percutaneous_coronary_intervention_and_the_management_of_acute_coronary_syndromes_in_patients_with_von_Willebrand_disease_ L2 - http://www.diseaseinfosearch.org/result/7418 DB - PRIME DP - Unbound Medicine ER -