Table 1.
Clinical features of 4 cases of chronic DIC in association with aortic aneurysm/dissection.
| Case 1 | Case 2 | Case 3 | Case 4 | |
|---|---|---|---|---|
| Age/sex | 84/F | 87/M | 91/F | 83/F |
| Causes of DIC | AA | AD | CIAA/IIAA | AA |
| Surgical procedures (EVAR) | Yes (pre-) | Yes (pre-) | Yes (post-) | None |
| Site(s)/event(s) of bleeding | Subcutaneous | Tooth extraction | Gingiva | GI tract |
| Data on DIC | ||||
| Platelet counts (/µL) | 64,000 | 73,000 | 100,000 | 62,000 |
| Fibrinogen (mg/dL) | 98 | 73 | 72 | 79 |
| FDP/D-dimer (µg/mL) | 101/49.8 | 96.8/24 | 109/51.4 | 177/81.7 |
| TAT/PIC (ng, µg/mL) | 40.5/12.7 | 58/17.6 | 49/NA | 69.2/12.6 |
| DIC score∗ | 11 | 7 | 6 | 7 |
| Treatment | ||||
| Supportive | None | PRBC | PRBC, FFP | PRBC, FFP, PC |
| Treatment for coagulopathy | ||||
| Initial | Heparin (DIV) + TA (DIV) | Heparin (SC) + TA (PO) | TA (DIV) | Heparin (DIV) + TA(DIV) |
| Later | Heparin (SC) + TA (PO) | Heparin (SC) + TA (PO) | Surgical (EVAR) | |
| Maintenance | Rivaroxaban (PO) | Rivaroxaban (PO) | ||
| Outcome | ||||
| DIC | Well controlled | Well controlled | Well controlled | Delayed control |
| Alive/dead | Alive | Alive | Alive | Dead∗∗ |
DIC = disseminated intravascular coagulation, AA = aortic aneurysm, AD = aortic dissection, FDP = fibrin degradation product, TAT = thrombin-antithrombin complex, PIC = plasmin-α2 plasmin inhibitor complex, GI = gastrointestinal, PRBC = packed red blood cell, FFP = fresh frozen plasma, PC = platelet concentrates, TA = tranexamic acid, EVAR = endovascular aortic repair, pre- = prior to DIC development, post- = after DIC development, DIV = drip infusion, SC = subcutaneous injection, PO = per oral, CIAA = common iliac artery aneurysm, and IIAA = internal iliac artery aneurysm. ∗Based on the DIC criteria of the Ministry of Health and Welfare of Japan; ∗∗died of aspiration pneumonia.