Persistent disseminated intravascular coagulation despite correction of endoleaks after thoracoabdominal endovascular aneurysm repair.

Disseminated intravascular coagulation (DIC) is a rare complication of endovascular aortic repair, commonly associated with type I or type III endoleaks. DIC is also known as consumption coagulopathy because excessive thrombin formation and secondary fibrinolysis leads to consumption of coagulation factors with hyperfibrinolysis and activation of platelets, which can lead to excessive bleeding. We present the case of an 80-year-old woman who had undergone thoracic endovascular aortic repair for a type B aortic dissection that was complicated by a series of recurrent endoleak-induced DICs requiring multiple thoracic endovascular aortic repair extensions to cover the entire thoracoabdominal aorta. The DIC persisted despite the resolution of the endoleaks.