Tranexamic Acid Successfully Controlled a Case of Disseminated Intravascular Coagulation Associated with Dissecting Aortic Aneurysm

Abstract

Disseminated intravascular coagulation (DIC) is an infrequent dissecting aortic aneurysm complication that occurs because of chronic consumption of coagulation factors. The optimal treatment of DIC has not been established yet. A 64-year-old man developed DIC after total arch replacement for acute aortic dissection Stanford type A. Surgical treatment was a curative treatment for DIC with dissecting aortic aneurysm, but we decided to treat him medically because of the descending aortic aneurysm diameter (50 mm) and his impaired Activities of daily living (ADL). However, the administration of FFP, ATIII, and recombinant thrombomodulin only had a temporary effect on DIC. The administration of tranexamic acid stabilized the coagulative and fibrinolytic parameters and relieved bleeding tendencies with no side effects. In addition, continuous oral administration of tranexamic acid induced thrombus formation in the false lumen and reduced the aortic aneurysm diameter (46 mm). We conclude that tranexamic acid is effective for DIC associated with dissecting aortic aneurysms.