Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominant vascular disease with a high risk of iron deficiency anemia secondary to epistaxis and gastrointestinal bleeding. Atrial fibrillation (AF) is associated with a high risk of ischemic stroke and oral anticoagulation therapy is indicated for its prevention. Percutaneous left atrial appendage closure (LAAC) is recommended to prevent stroke in patients with AF and high risk of bleeding such as HHT patients. However, double antiplatelet therapy at first, followed by long-term single antiplatelet therapy, is also recommended after the procedure to prevent device-related thrombus (DRT), which most HHT patients cannot tolerate.
