Operative and nonoperative management of chronic disseminated intravascular coagulation due to persistent aortic endoleak

• Published in: Journal of vascular surgery Vol. 59; no. 5; pp. 1426 - 1429
• Main Authors: Nienaber, Jeffrey J., MD, Duncan, Audra A., MD, Oderich, Gustavo S., MD, Pruthi, Rajiv K., MBBS, Nichols, William L., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2014
• Subjects: Aged; Aged, 80 and over; Aortic Aneurysm, Abdominal - diagnosis; Aortic Aneurysm, Abdominal - surgery; Aortic Aneurysm, Thoracic - diagnosis; Aortic Aneurysm, Thoracic - surgery; Aortography - methods; Blood Vessel Prosthesis Implantation - adverse effects; Chronic Disease; Disseminated Intravascular Coagulation - diagnosis; Disseminated Intravascular Coagulation - etiology; Disseminated Intravascular Coagulation - surgery; Disseminated Intravascular Coagulation - therapy; Endoleak - diagnosis; Endoleak - etiology; Endoleak - surgery; Endoleak - therapy; Endovascular Procedures - adverse effects; Humans; Male; Reoperation; Risk Factors; Surgery; Thrombocytopenia - complications; Tomography, X-Ray Computed; Treatment Outcome
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2013.05.097

Disseminated intravascular coagulation (DIC) due to endoleak is a rare complication following endovascular aneurysm repair. Two of the four previously reported cases occurred in patients with cirrhosis. We describe three patients with normal liver function who developed DIC due to delayed high-flow (type Ia or III) endoleaks. Two patients underwent successful surgical repair, and the third was managed medically. All three patients had chronic thrombocytopenia prior to developing an endoleak as did the four reported cases in the literature. We propose that thrombocytopenia, like cirrhosis, be considered a risk factor for DIC due to endoleaks in patients undergoing endovascular aneurysm repair.