Cor Vasa 2022, 64(6):665-669 | DOI: 10.33678/cor.2022.013

(Conservative treatment of chronic disseminated intravascular coagulation caused by chronic dissection and aneurysm of thoracoabdominal aorta with rivaroxaban)

Monika Fialová^{a, b}, Jiří Nový^a, Jakub Šimka^a, Magdalena Oravcová^a, Radovan Malý^a, Jiří Cyrany^{b, c}

^a I. interní kardioangiologická klinika, Lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Hradec Králové, Hradec Králové

^b Interní oddělení, Oblastní nemocnice Jičín, Jičín

^c II. interní gastroenterologická klinika, Lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Hradec Králové, Hradec Králové

Chronic disseminated intravascular coagulation (DIC) represents a life-threatening condition, in which activation of coagulation and fibrinolytic system occurs simultaneously, usually as a consequence of persistent weak or chronic intermittent activation of coagulation system. Especially in the population of elderly patients the possibility of aortic aneurysm and chronic aortic dissection as a precipitating factor needs to be considered. We present a case of 76-year-old woman with a history of thoracic endovascular aortic repair for aortic dissection Stanford type B four years earlier with repeated serious epistaxis during months, who was diagnosed with chronic DIC due to persisting aortic dissection and complicating huge thoracoabdominal aneurysm and was unsuitable for surgical or endovascular treatment for the general health condition and frailty status. We initiated a therapy with anticoagulation (rivaroxaban) which has led to successful outcome.

Keywords: Aortic aneurysm, Chronic aortic dissection, Direct oral anticoagulants, Disseminated intravascular coagulation, Rivaroxaban

Received: February 20, 2022; Revised: February 20, 2022; Accepted: February 21, 2022; Published: December 15, 2022  Show citation