Clinical Features of Aortic Aneurysm-associated Chronic Disseminated Intravascular Coagulation

  Objective  To investigate the clinical features of patient with aortic aneurysm-associated chronic disseminated intravascular coagulation (AA-DIC).

  Methods  The clinical data of 174 hospitalized patients from Peking Union Medical College Hospital who were diagnosed with aortic aneurysm from September 2009 to September 2011 were collected. The difference between aortic aneurysm patients with DIC (AA-DIC group) and those without DIC (non-DIC group) was compared.

  Results  Among these 174 patients with aortic aneurysm, 37 cases (21.3%) were associated with chronic DIC, including 4 (2.3%) with typical DIC and 33 (19.0%) with non-typical DIC. Patients from AA-DIC group has a significantly longer course than those from the non-DIC group (P=0.041). Abdominal aortic aneurysm and true aneurysm were most common seen in both groups. The proportion of mural thrombus and the incidences of complications including atherosclerosis, hypertension, and diabetes in the AA-DIC group were significantly higher than those in the non-DIC group (all P < 0.01). Patients with non-typical DIC also had abnormal coagulation disorders of varying degrees. Heparin/low molecular weight heparin (LMWH) improved both the clinical symptoms and laboratory parameters of patients in the AA-DIC group.

  Conclusions  Aortic aneurysm, especially abdominal aortic aneurysm, whether itself or in the perioperative period, can present as chronic DIC or coagulation disorders such as DIC. When patients with aortic aneurysm have a performance of mural thrombus formation or complicated with atherosclerosis, hypertension, or diabetes, they might appear chronic DIC. Aortic aneurysm should be considered when a patient shows manifestations of chronic DIC.