Rivaroxaban in a Patient With Disseminated Intravascular Coagulation Associated With an Aortic Aneurysm: A Case Report

Letters15 July 2014Rivaroxaban in a Patient With Disseminated Intravascular Coagulation Associated With an Aortic Aneurysm: A Case ReportTomoe Hayashi, MD, PhD, Noriharu Nakagawa, MD, Yasuko Kadohira, MD, Eriko Morishita, MD, PhD, and Hidesaku Asakura, MD, PhDTomoe Hayashi, MD, PhDFrom Kanazawa University School of Medicine, Kanazawa, Japan., Noriharu Nakagawa, MDFrom Kanazawa University School of Medicine, Kanazawa, Japan., Yasuko Kadohira, MDFrom Kanazawa University School of Medicine, Kanazawa, Japan., Eriko Morishita, MD, PhDFrom Kanazawa University School of Medicine, Kanazawa, Japan., and Hidesaku Asakura, MD, PhDFrom Kanazawa University School of Medicine, Kanazawa, Japan.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5014-3 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Progressive disseminated intravascular coagulation (DIC) causes bleeding due to consumption coagulopathy and excessive fibrinolytic activation and organ failure due to microcirculatory dysfunction (1). Disseminated intravascular coagulation associated with aortic aneurysms is characterized by marked fibrinolytic activation (2). When severe bleeding develops, DIC has conventionally been treated with a continuous heparin infusion (3), but the restrictions on patients are great and continuous intravenous infusion is problematic for outpatient care. Patient-administered subcutaneous heparin injections with a longer half-life are frequently selected (4), but the treatment burden remains high.Control of DIC with oral anticoagulants might reduce this burden substantially but requires ...References1. Levi M, Ten Cate H. Disseminated intravascular coagulation. N Engl J Med. 1999;341:586-92. [PMID: 10451465] CrossrefMedlineGoogle Scholar2. Takada A, Takada Y, Mori T, Sakaguchi S. Prevention of severe bleeding by tranexamic acid in a patient with disseminated intravascular coagulation. Thromb Res. 1990;58:101-8. [PMID: 1693450] CrossrefMedlineGoogle Scholar3. Jelenska MM, Szmidt J, Bojakowski K, Grzela T, Palester-Chlebowczyk M. Compensated activation of coagulation in patients with abdominal aortic aneurysm: effects of heparin treatment prior to elective surgery. Thromb Haemost. 2004;92:997-1002. [PMID: 15543326] CrossrefMedlineGoogle Scholar4. Ontachi Y, Asakura H, Arahata M, Kadohira Y, Maekawa M, Hayashi T, et al. Effect of combined therapy of danaparoid sodium and tranexamic acid on chronic disseminated intravascular coagulation associated with abdominal aortic aneurysm. Circ J. 2005;69:1150-3. [PMID: 16127203] CrossrefMedlineGoogle Scholar5. Randrianarisoa E, Kopp HG, Balletshofer BM, Jaschonek K, Kanz L, Haering HU, et al. Management of disseminated intravascular coagulopathy with direct factor Xa inhibitor rivaroxaban in Klippel-Trénaunay syndrome. Blood Coagul Fibrinolysis. 2013;24:766-70. [PMID: 24030117] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Kanazawa University School of Medicine, Kanazawa, Japan.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0131. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByBleeding Associated with Disseminated Intravascular CoagulationManagement of disseminated intravascular coagulation associated with aortic aneurysm and vascular malformationsManagement of Chronic Disseminated Intravascular Coagulation Associated with Aortic Aneurysm/DissectionSuccessful treatment with dabigatran for consumptive coagulopathy associated with extensive vascular malformationsAortic aneurysm and chronic disseminated intravascular coagulation: a retrospective study of 235 patientsTranexamic Acid Controlled Chronic Disseminated Intravascular Coagulation Associated with Aortic Dissection and Patent False Lumen for Three YearsAortic Aneurysm-associated Disseminated Intravascular Coagulation that Responded Well to a Switch from Warfarin to Rivaroxaban'Sailing in troubled waters'Use of Rivaroxaban for the Effective Management of Disseminated Intravascular Coagulation Associated with Abdominal Aortic Aneurysm 15 July 2014Volume 161, Issue 2Page: 158-159KeywordsAneurysmsAnticoagulantsDisseminated intravascular coagulationFibrinFibrinogenHemorrhageHeparinPlateletsStent implantation ePublished: 15 July 2014 Issue Published: 15 July 2014 CopyrightCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...