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Hoshina K, Kaneko M, Hosaka A, et al. Lessons learned from a case of abdominal aortic aneurysm accompanied by unstable coagulopathy. Case Rep Vasc Med. 2012;2012:265860doi: 10.1155/2012/265860.
Hoshina, K., Kaneko, M., Hosaka, A., Okamoto, H., Shigematsu, K., & Miyata, T. (2012). Lessons learned from a case of abdominal aortic aneurysm accompanied by unstable coagulopathy. Case reports in vascular medicine, 2012265860. https://doi.org/10.1155/2012/265860
Hoshina, Katsuyuki, et al. "Lessons learned from a case of abdominal aortic aneurysm accompanied by unstable coagulopathy." Case reports in vascular medicine vol. 2012 (2012): 265860. doi: https://doi.org/10.1155/2012/265860
Hoshina K, Kaneko M, Hosaka A, Okamoto H, Shigematsu K, Miyata T. Lessons learned from a case of abdominal aortic aneurysm accompanied by unstable coagulopathy. Case Rep Vasc Med. 2012;2012:265860. doi: 10.1155/2012/265860. Epub 2012 Aug 09. PMID: 22934232; PMCID: PMC3423788.
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Case Rep Vasc Med. 2012;2012:265860. doi: 10.1155/2012/265860. Epub 2012 Aug 09.

Lessons learned from a case of abdominal aortic aneurysm accompanied by unstable coagulopathy.

Case reports in vascular medicine

Katsuyuki Hoshina, Makoto Kaneko, Akihiro Hosaka, Hiroyuki Okamoto, Kunihiro Shigematsu, Tetsuro Miyata

Affiliations

  1. Division of Vascular Surgery, Department of Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

PMID: 22934232 PMCID: PMC3423788 DOI: 10.1155/2012/265860

Abstract

Preoperative examination for abdominal aortic aneurysms (AAAs) occasionally reveals an abnormal decrease in coagulation factors and thrombocytopenia, fulfilling the criteria for disseminated intravascular coagulation (DIC). Treatment of the underlying disorder is indispensable for alleviating DIC. We report an uncommon case of a patient with AAA and DIC who showed prolonged thrombocytopenia despite successful treatment of AAA and temporary recovery of coagulation factors. A 70-year-old man presented with AAA and shaggy aorta accompanied by DIC and underwent aneurysmectomy. Combined preoperative use of nafamostat mesilate and recombinant human soluble thrombomodulin was effective in controlling DIC. Although recovery of coagulation factors was observed after surgery, the thrombocytopenia continued throughout the postoperative course and was refractory to platelet transfusion. Because HPA antibody and PA-IgG were present, a trial administration of γ-globulin was performed; this resulted in rapid improvement of thrombocytopenia. Although DIC recurred again 2 weeks thereafter, coagulation factors subsequently recovered without any medication.

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