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Management of disseminated intravascular coagulation after thoracic endovascular aortic repair of type B aortic dissection: a case report
BACKGROUND: Disseminated intravascular coagulation (DIC) is a critical and rare complication after thoracic endovascular aortic repair (TEVAR) of type B aortic dissection. The optimal treatment of aortic dissection-related DIC remains controversial. CASE PRESENTATION: We herein describe the successf...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9295365/ https://www.ncbi.nlm.nih.gov/pubmed/35850643 http://dx.doi.org/10.1186/s12872-022-02768-6 |
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author | Liu, Hanbo Liu, Yi Lai, Jifu |
author_facet | Liu, Hanbo Liu, Yi Lai, Jifu |
author_sort | Liu, Hanbo |
collection | PubMed |
description | BACKGROUND: Disseminated intravascular coagulation (DIC) is a critical and rare complication after thoracic endovascular aortic repair (TEVAR) of type B aortic dissection. The optimal treatment of aortic dissection-related DIC remains controversial. CASE PRESENTATION: We herein describe the successful management of a 65-year-old man who presented with gingival bleeding and multiple subcutaneous petechiae and was proven to have DIC after TEVAR of aortic dissection. The patient had initially been discharged with improved laboratory tests after anticoagulation treatment followed by oral rivaroxaban for maintenance. However, he was readmitted with recurrent gingival bleeding 17 days later. The DIC was successfully controlled with a combination of anticoagulation and antifibrinolytics. After the patient was discharged, his treatment was switched to oral tranexamic acid and warfarin for maintenance. During a 15-month follow-up, the patient had no recurrence of hemorrhage symptoms and maintained stable coagulative and fibrinolytic parameters. CONCLUSIONS: Aortic dissection-related DIC requires long-term management under conservative treatment. The combination of warfarin and tranexamic acid may be a feasible method for long-term maintenance therapy. |
format | Online Article Text |
id | pubmed-9295365 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-92953652022-07-20 Management of disseminated intravascular coagulation after thoracic endovascular aortic repair of type B aortic dissection: a case report Liu, Hanbo Liu, Yi Lai, Jifu BMC Cardiovasc Disord Case Report BACKGROUND: Disseminated intravascular coagulation (DIC) is a critical and rare complication after thoracic endovascular aortic repair (TEVAR) of type B aortic dissection. The optimal treatment of aortic dissection-related DIC remains controversial. CASE PRESENTATION: We herein describe the successful management of a 65-year-old man who presented with gingival bleeding and multiple subcutaneous petechiae and was proven to have DIC after TEVAR of aortic dissection. The patient had initially been discharged with improved laboratory tests after anticoagulation treatment followed by oral rivaroxaban for maintenance. However, he was readmitted with recurrent gingival bleeding 17 days later. The DIC was successfully controlled with a combination of anticoagulation and antifibrinolytics. After the patient was discharged, his treatment was switched to oral tranexamic acid and warfarin for maintenance. During a 15-month follow-up, the patient had no recurrence of hemorrhage symptoms and maintained stable coagulative and fibrinolytic parameters. CONCLUSIONS: Aortic dissection-related DIC requires long-term management under conservative treatment. The combination of warfarin and tranexamic acid may be a feasible method for long-term maintenance therapy. BioMed Central 2022-07-18 /pmc/articles/PMC9295365/ /pubmed/35850643 http://dx.doi.org/10.1186/s12872-022-02768-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Liu, Hanbo Liu, Yi Lai, Jifu Management of disseminated intravascular coagulation after thoracic endovascular aortic repair of type B aortic dissection: a case report |
title | Management of disseminated intravascular coagulation after thoracic endovascular aortic repair of type B aortic dissection: a case report |
title_full | Management of disseminated intravascular coagulation after thoracic endovascular aortic repair of type B aortic dissection: a case report |
title_fullStr | Management of disseminated intravascular coagulation after thoracic endovascular aortic repair of type B aortic dissection: a case report |
title_full_unstemmed | Management of disseminated intravascular coagulation after thoracic endovascular aortic repair of type B aortic dissection: a case report |
title_short | Management of disseminated intravascular coagulation after thoracic endovascular aortic repair of type B aortic dissection: a case report |
title_sort | management of disseminated intravascular coagulation after thoracic endovascular aortic repair of type b aortic dissection: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9295365/ https://www.ncbi.nlm.nih.gov/pubmed/35850643 http://dx.doi.org/10.1186/s12872-022-02768-6 |
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