Chronic haemorrhagic disorder induced by dissecting aortic aneuryms

McLeod, Anke; Guddigan, B.J.; Mahon, W E

doi:10.1093/oxfordjournals.eurheartj.a061140

Cited by 11 publications

(4 citation statements)

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“…Several reports have already reported that that clinical presentations of AAD including anemia, depleting clotting factors and intravascular coagulopathy, result from the consumption of clotting factors in the false lumen [19, 20]. We also confirmed this DIC-like coagulopathy in the acute phase of AAD by ELISA and TEG in this study.…”

Section: Discussionsupporting

confidence: 87%

Consumption coagulopathy in acute aortic dissection: principles of management

Liu

Han

et al. 2017

J Cardiothorac Surg

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BackgroundThe effect of acute aortic dissection itself on coagulopathy or surgery-related coagulopathy has never been specifically studied. The aim of the present study was to perioperatively describe consumption coagulopathy in patients with acute aortic dissection.MethodsSixty-six patients with acute type A aortic dissection were enrolled in this study from January 2015 to September 2016. Thirty-six patients with thoracic aortic aneurysms were used as a control group during the same period. Consumption coagulopathy was evaluated using standard laboratory tests, enzyme-linked immunosorbent assay and thromboelastograghy at five perioperative time-points.ResultsA significant reduction in clotting factors and fibrinogen was observed at the onset of acute aortic dissection. Enzyme-linked immunosorbent assay and thromboelastograghy also revealed a persistent systemic activation of the coagulation system and the consumption of clotting factors. In contrast, although platelet counts were consistently low, we did not find that platelet function was more impaired in the acute aortic dissection group than the control group.ConclusionsAfter surgery, clotting factors and fibrinogen were more impaired than platelet function. Thus, we proposed that hemostatic therapy should focus on the rapid and sufficient supplementation of clotting factors and fibrinogen to improve consumption coagulopathy in patients with acute aortic dissection.

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Section: Discussionsupporting

confidence: 87%

Consumption coagulopathy in acute aortic dissection: principles of management

Liu

Han

et al. 2017

J Cardiothorac Surg

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“…Since then, several cases of DIC in the setting of aortic dissection have been reported. 2,3 The pathogenesis of DIC related to aortic dissection remains unclear. ten Cate et al 2 proposed the following possible mechanisms leading to DIC in patients with acute aortic dissection: (1) activation of factor XII by subendothelial tissues, such as collagen, and subsequent activation of the intrinsic coagulation system; (2) activation of factor VII by thromboplastic material of the aortic wall; or (3) triggering by fibrinolytic activator activity present in the aortic adventitia.…”

Section: Discussionmentioning

confidence: 99%

“…In the chronic phase of type B dissection, when the aneurysmal false lumen has evolved, surgical intervention is mandatory to prevent rupture. Additionally, when aortic dissection is accompanied by disseminated intravascular coagulation (DIC), surgical intervention is often necessary, [1][2][3][4] but it is associated with high mortality and morbidity owing to excessive blood loss during surgery. 5 Recent reports have suggested endovascular stent-grafting for type B aortic dissection as a potential alternative to surgical repair.…”

mentioning

confidence: 99%

Chronic Aortic Dissection Complicated by Disseminated Intravascular Coagulation: Successful Treatment with Endovascular Stent-Grafting

et al. 2003

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“…DIC is rarely caused by aortic dissection regardless of the time after onset. McLeod et al 1 . described a patient who had consumption coagulopathy associated with chronic dissection.…”

Section: Discussionmentioning

confidence: 99%

False Lumen Embolization with the Candy Plug Technique for Consumptive Coagulopathy after Aortic Repair for Chronic Dissection

Hasegawa

Nomura

Murakami

2019

EJVES Short Reports

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Introduction Chronic aortic dissection rarely causes consumptive coagulopathy due to disseminated intravascular coagulation (DIC). Report A 69 year old man who had previously undergone total arch replacement with the frozen elephant trunk procedure for chronic aortic dissection was transferred to our hospital because of sudden back pain. He had a bleeding from the right subscapular artery due to consumptive DIC caused by retrograde blood flow into a residual false lumen (FL). Percutaneous transcatheter embolisation was successfully performed, but DIC findings persisted. Thoracic endovascular aortic repair and FL embolisation with the candy plug technique were performed. Subsequently, DIC improved and FL thrombosis was safely accomplished. Discussion In this case, FL thrombosis was safely accomplished with the candy plug technique. This strategy expands options in patients with high risk for open repair.

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Chronic haemorrhagic disorder induced by dissecting aortic aneuryms

Cited by 11 publications

References 0 publications

Consumption coagulopathy in acute aortic dissection: principles of management

Consumption coagulopathy in acute aortic dissection: principles of management

Chronic Aortic Dissection Complicated by Disseminated Intravascular Coagulation: Successful Treatment with Endovascular Stent-Grafting

False Lumen Embolization with the Candy Plug Technique for Consumptive Coagulopathy after Aortic Repair for Chronic Dissection

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