Effective treatment with para-aminomethylbenzoic acid for chronic disseminated intravascular coagulation associated with aortic dissection

Cui, Qingya; Wu, Tianqin; Chen, Haifei; Qin, Longmei; Yu, Ziqiang; Shen, Huaying; Wang, Zhaoyue

doi:10.1097/mbc.0000000000000104

Cited by 5 publications

(5 citation statements)

References 18 publications

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“…Under these circumstances, blood component therapy (e.g., FFP and PC) is recommended to supplement the coagulation factors and platelets that have been consumed [ 9 ]. Several medical strategies have shown effectiveness in controlling DIC due to aortic dissection, including anticoagulation [ 6 , 14 , 15 ], antifibrinolytics [ 8 , 16 , 17 ], and a combination of both [ 11 , 18 , 19 ]. Although anticoagulation is not usually recommended for patients with severe DIC-associated bleeding [ 9 ] because it may cause bleeding complications elsewhere, some reports have shown the effectiveness and safety of anticoagulation treatment for DIC in patients with aortic dissection.…”

Section: Discussionmentioning

confidence: 99%

“…Antifibrinolytics can promote the formation of false lumen thrombosis and terminate the consumption of coagulation factors once the false lumen is completely thrombosed [ 9 ]. Because of concern regarding obvious hemorrhagic diathesis, some researchers have treated DIC by combining blood components with antifibrinolytics (e.g., tranexamic acid and para-aminomethylbenzoic acid) and avoiding anticoagulation [ 8 , 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

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Management of disseminated intravascular coagulation after thoracic endovascular aortic repair of type B aortic dissection: a case report

Liu

Lai

2022

BMC Cardiovasc Disord

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Background Disseminated intravascular coagulation (DIC) is a critical and rare complication after thoracic endovascular aortic repair (TEVAR) of type B aortic dissection. The optimal treatment of aortic dissection-related DIC remains controversial. Case presentation We herein describe the successful management of a 65-year-old man who presented with gingival bleeding and multiple subcutaneous petechiae and was proven to have DIC after TEVAR of aortic dissection. The patient had initially been discharged with improved laboratory tests after anticoagulation treatment followed by oral rivaroxaban for maintenance. However, he was readmitted with recurrent gingival bleeding 17 days later. The DIC was successfully controlled with a combination of anticoagulation and antifibrinolytics. After the patient was discharged, his treatment was switched to oral tranexamic acid and warfarin for maintenance. During a 15-month follow-up, the patient had no recurrence of hemorrhage symptoms and maintained stable coagulative and fibrinolytic parameters. Conclusions Aortic dissection-related DIC requires long-term management under conservative treatment. The combination of warfarin and tranexamic acid may be a feasible method for long-term maintenance therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Management of disseminated intravascular coagulation after thoracic endovascular aortic repair of type B aortic dissection: a case report

Liu

Lai

2022

BMC Cardiovasc Disord

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“…The course of this patient suggested that the administration of edoxaban is useful for DIC due to aortic dissection without severe adverse events. Previous reports of DIC caused by vascular disease have described the effectiveness of rTM ( 6 - 9 ), low-molecular-weight heparin (LMWH) ( 10 - 13 ), nafamostat mesylate ( 14 ), and para-aminomethylbenzoic acid (PAMBA) ( 15 ). However, the intravenous administration of these drugs places a considerable burden on patients.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment with Edoxaban for Disseminated Intravascular Coagulation in a Case of Aortic Dissection Complicated with Immune Thrombocytopenic Purpura

et al. 2020

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A 70-year-old woman was hospitalized for exacerbation of chronic idiopathic thrombocytopenic purpura (ITP) and disseminated intravascular coagulation (DIC) from old aortic dissection. Initially, we increased the dose of prednisolone for ITP. However, her bleeding tendency caused by DIC worsened despite the rapid recovery of her platelet count, and the required amount of fresh-frozen plasma for transfusion increased. The administration of edoxaban for atrial fibrillation led to the marked improvement of her DIC status without serious adverse events. This case suggests that a direct oral anticoagulant may be an effective treatment for DIC caused by aortic dissection.

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“…Thus, the right renal artery is only involved, if there is the substantial circumferential extension of the AAD [ 3 - 4 ]. From our review, the diagnosis of several patients was extremely delayed, often until hemodynamic stability is compromised (Table 1 ) [ 5 - 10 ].…”

Section: Discussionmentioning

confidence: 99%

How an Elevated Creatinine Level Can Deter the Diagnosis of Acute Aortic Dissection

Mohamed¹,

Hamid²

2018

Cureus

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Acute aortic dissection (AAD) classically manifests with sudden, severe chest pain radiating to the back or abdomen, often described as ripping or tearing sensation. Considering its abrupt onset, the diagnosis requires a high index of suspicion prompting immediate imaging using computed tomography (CT) with contrast. However, the use of contrast is a relative contraindication in the patients with renal compromise and acute care physicians are often deterred from contrast use in these patients. Herein, we present an unusual case of hematuria as the presenting symptom of a developing the Stanford type-A AAD.A 65-year-old female presented with sudden, severe chest pain radiating to her lower back. She reported that her urine color was 'pink' on the previous day and was becoming more 'red-colored' as the day progressed. The next morning, she began feeling a 10/10 crushing-type chest pain that was relieved when she lay on her left side and was associated with nausea, vomiting, and diaphoresis. The urine analysis revealed gross hematuria. The laboratory findings revealed a creatinine of 1.3. Due to her elevated creatine levels and possible acute kidney injury, a computed tomography (CT) without contrast was performed initially, which did not reveal an AAD. However, the index of suspicion was still high for the AAD, after prompt discussions about the risk of using contrast and contrast nephropathy versus the risks of potential complications, if AAD was missed. Further evaluation with CT of the chest and abdomen, with contrast, was obtained with the patients' consent, which revealed a Stanford type-A AAD starting proximally from the aortic arch and extending to the common iliac.In conclusion, the clinical presentations of AAD are more heterogeneous. Hematuria in the presence of high index of suspicion and symptoms of AAD could indicate the extension of the involvement of the renal arteries. Prompt CT with contrast may be indicated despite relative contraindications from the laboratory findings.

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Effective treatment with para-aminomethylbenzoic acid for chronic disseminated intravascular coagulation associated with aortic dissection

Cited by 5 publications

References 18 publications

Management of disseminated intravascular coagulation after thoracic endovascular aortic repair of type B aortic dissection: a case report

Management of disseminated intravascular coagulation after thoracic endovascular aortic repair of type B aortic dissection: a case report

Successful Treatment with Edoxaban for Disseminated Intravascular Coagulation in a Case of Aortic Dissection Complicated with Immune Thrombocytopenic Purpura

How an Elevated Creatinine Level Can Deter the Diagnosis of Acute Aortic Dissection

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