Total Endovascular Repair by Sandwich Technique Thoracoabdominal Aortic Dissecting Aneurysm with Aneurysm Related Disseminated Intravascular Coagulation (DIC)

Abstract

Purpose: To present a rare case of thoracoabdominal aortic dissecting aneurysm combined with aneurysm related disseminated intravascular coagulation (DIC) and the novel treatment of total endovascular aneurysm repair (EVAR) with Sandwich technique.Case Report: A 78-year-old man was admitted with thoracoabdominal aortic dissecting aneurysm (TAADA) combined with bilateral iliac artery aneurysm (BIAA) accompanied by aneurysm related DIC. With adequate transfusion of blood components and a continuous subcutaneous injection of low molecular weight heparin, surgical repair of the multiple aortic lesions was carried out successfully. He received a total endovascular repair by sandwich technique to reconstruct all visceral branches.Postoperative laboratory evaluation demonstrated resolution of the coagulopathy. The optimal quality of life were achieved without any coagulopathy, paraplegia, pelvic organs ischemia or claudication and with an ideal blood pressure control during the 2-years' following-up. Conclusion:Total endovascular aneurysm repair by sandwich technique appears to be a feasible, safe, and effective treatment for the management of thoracoabdominal aortic dissecting aneurysm. Confidential conclusion needs more cases to be done.