Thoracic endovascular repair for disseminated intravascular coagulation associated with chronic type B aortic dissection

Abstract

Objectives Chronic disseminated intravascular coagulation is a rare complication of aortic dissection, and its optimal treatment remains controversial. Methods We present a 78-year-old man with repeated hemorrhagic events by disseminated intravascular coagulation due to chronic aortic dissection treated by thoracic endovascular aortic repair. Results Computed tomography angiography at three months revealed a completely thrombosed false lumen from the distal aortic arch to the descending aorta at the celiac artery level. Platelets and D-dimer levels remained stable, and the patient was doing well without hemorrhagic complications. Conclusions Endovascular repair was effective for disseminated intravascular coagulation due to chronic type B aortic dissection.

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

“…Open surgery may be a radical treatment to correct the hemorrhagic diathesis but is quite invasive [ 13 ]. With rapid advances in endovascular technology, different methods for sealing re-entry tears have emerged [ 2 , 4 , 7 , 12 ]. However, surgical or endovascular intervention may not be suitable for all patients, especially those with high operative risk.…”

“…Nevertheless, disseminated intravascular coagulation (DIC), a rare and potentially fatal complication of endovascular treatment, can develop because of the consumption of coagulation factors in aortic remodeling [ 2 , 3 ]. Although several reports have described the treatment of DIC associated with aortic dissection, including surgery and medical therapies [ 4 – 7 ], the optimal treatment of aortic dissection-related DIC has not been established.…”