Management of Chronic Disseminated Intravascular Coagulation Associated with Aortic Aneurysm/Dissection

Abstract

Disseminated intravascular coagulation (DIC) is a systemic life-threatening process that can cause thrombosis and hemorrhage. Chronic DIC has been associated with aortic aneurysm/dissection. Aortic aneurysm/dissection should be included in the differential diagnosis of elderly patients with hemorrhagic diathesis due to DIC of uncertain etiology. Treatment depends on various factors, including the severity of underlying disease, extent of DIC, and patient comorbidities, as well as the ability of the patient to maintain activities of daily living once discharged from the hospital. This report describes the clinical characteristics of four elderly patients with chronic DIC associated with aortic aneurysm/dissection who were treated in our institution. We also offer the recommendations around most appropriate nonsurgical treatment of these patients.

Large cavernous carotid artery aneurysm with spontaneous thrombosis: is there more to a change in morphology than there seems to be? Illustrative case

“…13 Since the report by Fine et al in 1967 showing that AAA induces DIC, the incidence of AAA with symptomatic DIC caused by excess consumption of coagulation factors has been reported as 0.5% to 4%, and perioperative evaluation of hemostatic derangement should be considered, even if the patient with AAA has no clinical manifestation of hemorrhagic diathesis. 14,15 In typical cases of DIC, those caused by sepsis, inflammatory cytokines inhibit the expression of TM, an anticlotting protein in the vascular endothelium, thereby activating intravascular coagulation. In most cases, we would expect fibrinolysis to be activated as the body attempts to dissolve the multiple microthrombi produced by such abnormally activated coagulation.…”

“… 13 Since the report by Fine et al in 1967 showing that AAA induces DIC, the incidence of AAA with symptomatic DIC caused by excess consumption of coagulation factors has been reported as 0.5% to 4%, and perioperative evaluation of hemostatic derangement should be considered, even if the patient with AAA has no clinical manifestation of hemorrhagic diathesis. 14 , 15 …”

Case of chronic disseminated intravascular coagulation associated with abdominal aortic aneurysm with repeated bleeding after cold snare polypectomy

“…3,4 However, delayed and repeated bleeding may occur after CSP in patients with coagulation abnormalities. Additionally, chronic DIC can occur in patients with cardiovascular disease, including aortic aneurysms, 5 and bleeding may contribute to deterioration of DIC. Ideally, coagulation function should be assessed prior to CSP, otherwise at the time of the first bleeding event.…”

Aneurisma aórtico abdominal asociado a coagulación intravascular diseminada crónica: una complicación rara

“…Existen pocos reportes de coagulación intravascular diseminada crónica como complicación en pacientes con aneurisma aórtico abdominal, y sobre sus manifestaciones clínicas, hallazgos de laboratorio y tratamiento. Por otra parte, los mecanismos, la duración y la respuesta terapéutica no se conocen bien [5][6][7][8] . Se considera un reto diagnóstico y terapéutico, dada la baja frecuencia de esta complicación en pacientes con aneurisma aórtico abdominal.…”