Use of Rivaroxaban for the Effective Management of Disseminated Intravascular Coagulation Associated with Abdominal Aortic Aneurysm

Kawano, Hiroaki; Hata, Tomoko; Uda, Akiko; Maemura, Koji

doi:10.2169/internalmedicine.54.4942

Cited by 19 publications

(23 citation statements)

References 18 publications

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“…Accordingly, Xa inhibitor has recently been suggested as an alternative to subcutaneous heparin administration for aortic DIC if renal function is retained (17-19). TEVAR is a radical way of curing the symptoms of DIC (20) and also reduces the aortic-specific mortality in the chronic phase (21).…”

Section: Discussionmentioning

confidence: 99%

Tranexamic Acid Controlled Chronic Disseminated Intravascular Coagulation Associated with Aortic Dissection and Patent False Lumen for Three Years

et al. 2017

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The management of chronic disseminated intravascular coagulation (DIC) caused by aortic dissection has not yet been established. Even in cases where surgical correction is performed, therapeutic control of systemic hemorrhaging is still required. We herein report the successful treatment of a case of aortic dissection with a patent false lumen using tranexamic acid for acute exacerbation of chronic DIC. Oral administration of 1,500 mg tranexamic acid per day stabilized the coagulative and fibrinolytic parameters and relieved bleeding tendencies with no side effects. Heparin was administered periodically for the management of hemodialysis. This favorable result continued for up to 3 years.

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Section: Discussionmentioning

confidence: 99%

Tranexamic Acid Controlled Chronic Disseminated Intravascular Coagulation Associated with Aortic Dissection and Patent False Lumen for Three Years

et al. 2017

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“…Chronic DIC associated with aortic aneurysm/dissection is a primary cause of hemorrhagic diathesis in elderly patients. In aortic aneurysms, endothelial disruption associated with either dissection or atheromatous plaque rupture leads to the exposure of collagen and tissue factor, triggering the coagulation cascade, including the activation of FX, and leading to excess consumption of clotting factors and the induction of DIC [13]. Similarly, in aortic dissection, chronic expansion of the false lumen activates extrinsic tissue factors and intrinsic coagulation factors, leading to the exposure of subendothelial collagen tissue and the pooling of a high volume of blood in the false lumen.…”

Section: Discussionmentioning

confidence: 99%

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

Koba¹,

Yamaguchi²,

Miki³

et al. 2019

Case Reports in Hematology

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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.

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“…We were the first to report that rivaroxaban - an oral activated factor X inhibitor - was effective for the treatment of DIC associated with aortic aneurysms ( 5 ). Subsequently, other authors have reported that rivaroxaban is effective for treating DIC associated with abdominal aortic aneurysms ( 15 ). Based on our earlier experience, in which a patient was treated with rivaroxaban (after we obtained approval from our hospital's medical ethics committee and after obtaining informed consent), following confirmatory reports from others, and after verifying that the PT-INR had been corrected following the discontinuation of warfarin, we initiated treatment with rivaroxaban.…”

Section: Discussionmentioning

confidence: 99%

Aortic Aneurysm-associated Disseminated Intravascular Coagulation that Responded Well to a Switch from Warfarin to Rivaroxaban

et al. 2017

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We describe a case in which uncontrolled chronic disseminated intravascular coagulation (DIC) caused by an aortic aneurysm that was exacerbated by chemotherapy for lung cancer, showed dramatic improvement when warfarin, which was being administered for atrial fibrillation, was replaced by rivaroxaban, a direct oral anticoagulant (DOAC). The present case is interesting because a DOAC was effective in treating DIC due to an aortic aneurysm, whereas warfarin, another oral anticoagulant, was ineffective. In controlling DIC, it is important to inhibit activated coagulation factors such as thrombin and activated factor X, rather than the coagulation factors, which act as substrates.

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Use of Rivaroxaban for the Effective Management of Disseminated Intravascular Coagulation Associated with Abdominal Aortic Aneurysm

Cited by 19 publications

References 18 publications

Tranexamic Acid Controlled Chronic Disseminated Intravascular Coagulation Associated with Aortic Dissection and Patent False Lumen for Three Years

Tranexamic Acid Controlled Chronic Disseminated Intravascular Coagulation Associated with Aortic Dissection and Patent False Lumen for Three Years

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

Aortic Aneurysm-associated Disseminated Intravascular Coagulation that Responded Well to a Switch from Warfarin to Rivaroxaban

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