Successful multi-vessel percutaneous coronary intervention with bivalirudin in a patient with severe hemophilia A: a case report and review of literature.
We describe a 64-year-old male with severe hemophilia A (factor VIII-dependent), acute myocardial infarction (MI) and congestive heart failure (CHF) who underwent successful multi-vessel percutaneous coronary intervention (PCI). The patient was administered factor VIII transfusion to maintain activity levels between 60-80%. Anticoagulation during the PCI procedure was maintained with the direct thrombin inhibitor, bivalirudin. There were no procedural complications and the patient was discharged home the following day. These results suggest that bivalirudin may be used effectively in patients at very high risk of bleeding with enhanced procedural safety.
Arora
Umesh K
UK
University of South Florida, Tampa, USA. umeen2111@aol.com
Dhir
Meeney
M
Cintron
Guillermo
G
Strom
Joel A
JA
D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000008:administration & dosage*; D000991:Antithrombins / Q000008:administration & dosage*; D016913:Blood Component Transfusion; D017023:Coronary Angiography; D005169:Factor VIII / Q000008:administration & dosage; D006467:Hemophilia A / Q000150:complications / Q000628:therapy; D006629:Hirudins / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000628:therapy; D010446:Peptide Fragments / Q000008:administration & dosage*; D015641:Radiography, Interventional; D011994:Recombinant Proteins / Q000008:administration & dosage*
D000925:Anticoagulants; D000991:Antithrombins; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; D005169:Factor VIII; C074619:bivalirudin