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Case Reports
. 2024 Sep 24;16(9):e70102.
doi: 10.7759/cureus.70102. eCollection 2024 Sep.

Thoracic Radiofrequency Ablation in a Patient With Von Willebrand's Disease: A Case Report

William J Brandt  1 , Tatiana J Han  2 , Giustino Varrassi  3 , Sahar Shekoohi  4 , Alan D Kaye  4
Affiliations
Case Reports

Thoracic Radiofrequency Ablation in a Patient With Von Willebrand's Disease: A Case Report

William J Brandt et al. Cureus. .

Abstract

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.

Keywords: ablation; interventional pain; radiofrequency; thoracic medial branch blocks; von willebrand’s disease.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Thoracic medial branch blocks: lateral view.
Figure 2
Figure 2. Thoracic medial branch blocks: anterior-posterior view.
Figure 3
Figure 3. Thoracic radiofrequency ablation: anterior-posterior view.
Figure 4
Figure 4. Thoracic radiofrequency ablation: lateral view.
See this image and copyright information in PMC

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