Disseminated intravascular coagulation after endovascular aneurysm repair: resolution after aortic banding.

Abstract

Disseminated intravascular coagulation (DIC) has been shown to affect 2% to 4% of patients with abdominal aortic aneurysms. In rare cases of DIC caused by aneurysms, operative repair has been curative. Endovascular aneurysm repair (EVAR) has been established as an effective treatment. We report a 73-year-old man in whom severe bleeding developed from groin incisions and cannulae sites immediately after EVAR. An intraoperative angiogram showed a type I endoleak, but the procedure had to be abandoned due to continued bleeding. Blood tests confirmed a diagnosis of disseminated intravascular coagulation that persisted chronically 3 months postoperatively. Attempts to repair the endoleak with stenting were unsuccessful, resulting in persistence of disseminated intravascular coagulation. This resolved after successful treatment of the endoleak with aortic banding.