Rapid aspirin desensitisation to aid use in coronary artery disease: Illustrative case series of local practice

Several international cardiac units have found rapid aspirin desensitisation to be safe and effective. The management of acute coronary syndromes requires dual anti-platelet therapy post percutaneous coronary intervention. For patients with aspirin hypersensitivity this poses a problem. The Groote Schuur Allergy Unit in collaboration with the Cardiology service implemented a rapid aspirin desensitisation protocol at C27 Coronary Care Unit in 2016. The following case demonstrates how the protocol was adjusted to make the procedure even safer. Summative data are also provided of the other cases desensitised successfully to date despite the variation in the clinical presentation of their aspirin hypersensitivity.