Tranexamic Acid Use in a Patient with a Life-threatening Bleed Exacerbated by Coagulopathy Due to an Aortic Aneurysm with an Endoleak: A Case Report

Tranexamic acid (TXA) is an anti-fibrinolytic agent that inhibits plasminogen activation by binding to its lysine receptor sites and preventing its conversion to plasmin. It stabilizes clots to reduce bleeding and has been used in the setting of trauma, heavy menstrual bleeding, and hematologic malignancies. To our knowledge, there is no mention in the literature of medical management with TXA to treat a life-threatening hemorrhage in the setting of non-operative, endoleakage-induced, chronic disseminated intravascular coagulation (DIC). This case report summarizes the successful use of TXA in a patient with DIC secondary to multiple aortic aneurysms and endoleakage in an effort to stop the expansion of a life-threatening gluteal hematoma not amenable to surgical or vascular intervention.