False Lumen Embolization to Treat Disseminated Intravascular Coagulation After Thoracic Endovascular Aortic Repair of Type B Aortic Dissection

J Endovasc Ther. 2015 Dec;22(6):938-41. doi: 10.1177/1526602815607185. Epub 2015 Sep 17.

Abstract

Purpose: To present a rare case of disseminated intravascular coagulation (DIC) after thoracic endovascular aortic repair (TEVAR) and its novel treatment.

Case report: A 55-year-old man presented with DIC 10 months after TEVAR for chronic type B aortic dissection and descending thoracic aortic aneurysm. He had persistent retrograde flow in the false lumen with a stable aneurysm diameter. The false lumen was embolized with multiple Amplatzer plugs, which promoted false lumen thrombosis. Laboratory evaluation on postoperative day 7 demonstrated resolution of the coagulopathy. Follow-up at 18 months revealed no recurrent DIC; computed tomography angiography showed a stable aortic diameter and excluded thoracic aneurysm sac.

Conclusion: This case demonstrates an unusual, potentially fatal postoperative complication of endovascular treatment of type B aortic dissections successfully treated with an innovative endovascular solution.

Keywords: disseminated intravascular coagulation; embolization; false lumen; thoracic endovascular aortic repair; type B aortic dissection; vascular plug.

Publication types

  • Case Reports

MeSH terms

  • Aortic Aneurysm, Thoracic / classification
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortic Dissection / classification
  • Aortic Dissection / surgery*
  • Disseminated Intravascular Coagulation / therapy*
  • Embolization, Therapeutic*
  • Endovascular Procedures*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / therapy*