Successful Treatment of Aneurysm-Associated Disseminated Intravascular Coagulation with Endovascular Aneurysm Repair(EVAR)

(Department of Cardiovascular Surgery, Nagano Chuo Hospital, Nagano, Japan)

Yu Matsumura Yuki Nakayama Fumitaka Yamaki
A 80-year-old woman was referred to our hospital for coagulation abnormality and huge abdominal aortic aneurysm(AAA). She had persistent hemorrhage from the surgical wound after the operation for her cubital tunnel syndrome 5 days before. Enhanced computed tomography image revealed AAA with a maximum diameter of 91mm. Laboratory data were compatible with disseminated intravascular coagulation(DIC). Due to the marked hemorrhagic status, we thought the open repair of AAA was an extremely risky procedure. We initiated the medical treatment with gabexate mesilate. However, the hemorrhage continued after 2 weeks of medical therapy. We performed endovascular aneurysm repair(EVAR). DIC improved after the procedure. Postoperative enhanced computed tomography image showed regression of the aneurysm with no endoleak. EVAR might be an acceptable procedure for AAA with DIC.
  Jpn. J. Cardiovasc. Surg. 42:447-451(2013)

Keywords:abdominal aortic aneurysm(AAA), disseminated intravascular coagulation(DIC), endovascular aneurysm repair(EVAR)