Anticoagulation in Complex Thrombophilia: APS, Factor V Leiden, and von Willebrand Factor Type 2
Comparison of Marcumar/Warfarin with Rivaroxaban, Apixaban, Edoxaban, and Dabigatran Etexilate Unfortunately, many patients are not routinely tested for von Willebrand disease, antiphospholipid syndrome (APS), or lupus , which can lead to delayed diagnosis of underlying clotting or bleeding disorders. Introduction The coexistence of Antiphospholipid Syndrome (APS) , Factor V Leiden mutation , and von Willebrand factor type 2 (vWF type 2) defect represents a highly complex and clinically challenging hemostatic profile. These disorders affect the coagulation system in different and sometimes opposing ways: APS and Factor V Leiden increase the risk of thrombosis, whereas certain forms of von Willebrand disease (particularly type 2 variants) may increase bleeding tendencies. Selecting the most appropriate anticoagulant therapy in such a situation requires careful clinical judgment and individualized risk assessment. Physicians must balance the high risk of recurrent thrombosis a...