Severe aortic valve stenosis-induced high flow shear stress can lead to conformational changes and excessive consumption of high molecular weight von Willebrand factor multimers, resulting in an increased release of Ang-2 and a direct elevation of the risk of bleeding.[13] Direct oral anticoagulant administration can increase the risk of gastrointestinal AD bleeding by 4.16 times, and antiplatelet agents can have a similar effect.[14]. This evidence concerns the gene VWF and stricture.