Deteriorating consumptive coagulopathy with type III endoleak following endovascular repair for abdominal aortic aneurysm associated with liver cirrhosis.
OBJECTIVE
To report a case of deteriorating consumptive coagulopathy with type III endoleak following endovascular aneurysm repair (EVAR) of the abdominal aorta associated with liver cirrhosis.


METHODS
A 72-year-old man with liver cirrhosis developed type III endoleak following EVAR. Spontaneous intramuscular hematoma developed due to deteriorating consumptive coagulopathy induced by type III endoleak and liver dysfunction. Although additional EVAR was performed at 52 months after primary EVAR, the patient died due to multiorgan failure and multifocal hematoma of the muscles and subserosa.


CONCLUSIONS
EVAR for patients with liver dysfunction and coagulopathy should be considered with great caution. We suggest that prompt and adequate treatment using an endovascular technique or surgical repair should be performed for patients with liver dysfunction, coagulopathy, and turbulent endoleak, even if the coagulopathies are worse compared to before EVAR.
Higashiura
Wataru
W
Department of Radiology, Nara Medical University, Kashihara, Nara, Japan. wataruhigashiura@hotmail.com
Kichikawa
Kimihiko
K
Sakaguchi
Shoji
S
Kubota
Yasushi
Y
Nagata
Takeshi
T
Nishimine
Kiyoshi
K
Ide
Koichi
K
Tabayashi
Nobuoki
N
Taniguchi
Shigeki
S
Uchida
Hideo
H
D000368:Aged; D015901:Angiography, Digital Subtraction; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D016913:Blood Component Transfusion; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D004211:Disseminated Intravascular Coagulation / Q000150:complications / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D017809:Fatal Outcome; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D010949:Plasma; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D011138:Polytetrafluoroethylene