Abstract
We report 3 cases of aneurysms in which platelet consumption may last until surgical resection of the aneurysm, and two of whom manifest with clinical DIC. The unique features in these 3 aneurysms are that they had a vortical flow in the aneurysms and a lack of mural thrombus. Two had sharp bends at the base of the aneurysm, and one had saccular projected aneurysm. The vortical flows may prevented accumulation of mural thrombin. We examined plasma level of βTG and PF4 by direct puncture of the aneurysm in two cases. The platelet secreting granule levels were higher in the aneurysms than in other proximal arterial levels. We also measured plasma TXB2 and FPA levels, and obtained a higher values in the aneurysm. We suspect that coagulation and fibrinolytic processes were acceleated in the aneurysms. Preoperative low dose heparin corrected the bleeding diathesis, and platelet transfusion was also effective, and surgical resection halted this coagulopathy. We concluded that DIC associated with aortic aneurysms may be caused mainly by platelet dysfunction. The vortex in huge aneurysms may cause chronic activation and consumption of platelets.
