Successfully Managed Aortic Aneurysm by Endovascular Treatment and Sequential Surgical Replacement in a Patient with Chronic Consumptive Coagulopathy.
10.3904/kjm.2016.90.6.537
- Author:
Jee Hyun KIM
1
;
Bum Hee YANG
;
Ju Hee LEE
;
Sang Yeub LEE
;
Jang Whan BAE
;
Kyung Kuk HWANG
;
Sang Min KIM
Author Information
1. Regional Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea. sangmin3410@gmail.com
- Publication Type:Case Report
- Keywords:
Aortic aneurysm;
Coagulopathy
- MeSH:
Aged;
Aorta;
Aortic Aneurysm*;
Aortic Aneurysm, Abdominal;
Aortic Aneurysm, Thoracic;
Blood Platelets;
Endoleak;
Hemorrhage;
Humans;
Leg;
Mortality;
Platelet Aggregation Inhibitors;
Platelet Transfusion;
Purpura;
Ulcer
- From:Korean Journal of Medicine
2016;90(6):537-541
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Aortic aneurysm-induced chronic consumptive coagulopathy is a very rare complication but can be a source of critical complications and mortality. A 72-year-old man presented with a rapidly expanding descending thoracic aortic aneurysm with a penetrating ulcer and an infrarenal abdominal aortic aneurysm complicated by chronic coagulopathy. We were aware of the bleeding risk during surgical replacement based on the patient's chronic coagulopathy status and successfully performed endovascular repair of the thoracic aortic aneurysm with a penetrating ulcer. Platelet transfusion, antiplatelet agents, and proteinase inhibitors improved the coagulopathy. A delayed type Ib endoleak developed, and the coagulopathy recurred 2 months later when the patient presented with purpura of both lower legs. We successfully managed the condition by elective surgical replacement of the entire aorta after improving the coagulopathy with platelet replacement and administration of proteinase inhibitors.
