Thoracic Radiofrequency Ablation in a Patient With Von Willebrand's Disease: A Case Report
William J Brandt1, Tatiana J Han2, Giustino Varrassi3
1School of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA.
Congenital bleeding disorders involve specific deficiencies in factors that can alter hemostasis, increasing the risk of bleeding. This case report describes a patient with Von Willebrand's disease who was diagnosed with severe thoracic facet arthritis with pain scores of 9/10. An antihemophilic factor (vWF, Humate-P) injection was administered by a hematologist just before thoracic medial branch blocks. Rather than receiving traditional second thoracic medial branch blocks on another day, the patient, after documenting complete relief of his symptoms with 1% lidocaine, received bilateral T6-8 thoracic radiofrequency ablations, which resulted in complete resolution of his symptoms. A second dose of Humate-P was delivered 24 hours post-procedure. Careful planning with hematologists can enable safe and effective interventional pain procedures in patients with congenital hematologic disorders. This appears to be the first case report in world literature of a patient with Von Willebrand's disease successfully receiving thoracic radiofrequency ablations.
Congenital bleeding disorders involve specific deficiencies in factors that can alter hemostasis, increasing the risk of bleeding. This case report describes a patient with Von Willebrand's disease who was diagnosed with severe thoracic facet arthritis with pain scores of 9/10. An antihemophilic factor (vWF, Humate-P) injection was administered by a hematologist just before thoracic medial branch blocks. Rather than receiving traditional second thoracic medial branch blocks on another day, the patient, after documenting complete relief of his symptoms with 1% lidocaine, received bilateral T6-8 thoracic radiofrequency ablations, which resulted in complete resolution of his symptoms. A second dose of Humate-P was delivered 24 hours post-procedure. Careful planning with hematologists can enable safe and effective interventional pain procedures in patients with congenital hematologic disorders. This appears to be the first case report in world literature of a patient with Von Willebrand's disease successfully receiving thoracic radiofrequency ablations.
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