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Preoperative hepatic insufficiency and type III endoleak: a confirmed potential fatal association following endovascular treatment

^a Department of Thoracic and Cardiovascular Surgery and Angiology, Dupuytren University Hospital, Ave Martin Luther King, 87042 Limoges, France
^b Department of Cardiac and Vascular Surgery, Hôpital Haut-Lévèque, Bordeaux University Hospital, 33604 Pessac, France

*Corresponding author. Department of Cardio-Vascular Surgery, Hôpital Haut Lévèque, Avenue de Magellan, 33604 Bordeaux-Pessac, France. Tel.: +33-5-57-65-64-37; fax: +33-5-57-65-81-57.

E-mail address: louis.labrousse{at}chu-bordeaux.fr (L. Labrousse).

Consumptive coagulopathy is known to occur in patients with aneurysm, especially in the thoracic localization. Compared to open chest surgery, the endovascular treatment leaves in place a large thrombosed aneurysmal sac, which might induce and/or exacerbate the coagulopathy. Although exceptional, some recent reports have raised the potential disastrous issue related to this complication. We report the case of a 74-year-old patient treated for an asymptomatic thoracic aorta aneurysm by endoprosthesis who developed a fatal disseminated intravascular coagulopathy. This complication has been related to a type III endoleak associated with a preoperative hepatic insufficiency.

Key Words: Thoracic aneurysm; Coagulopathy