(Conservative treatment of chronic disseminated intravascular coagulation caused by chronic dissection and aneurysm of thoracoabdominal aorta with rivaroxaban)

Chronic disseminated intravascular coagulation (DIC) represents a life-threatening condition, in which activation of coagulation and ﬁ brinolytic system occurs simultaneously, usually as a consequence of per- sistent weak or chronic intermittent activation of coagulation system. Especially in the population of elderly patients the possibility of aortic aneurysm and chronic aortic dissection as a precipitating factor needs to be considered. We present a case of 76-year-old woman with a history of thoracic endovascular aortic repair for aortic dissection Stanford type B four years earlier with repeated serious epistaxis during months, who was diagnosed with chronic DIC due to persisting aortic dissection and complicating huge thoracoabdominal aneurysm and was unsuitable for surgical or endovascular treatment for the general health condition and frailty status. We initiated a therapy with anticoagulation (rivaroxaban) which has led to successful outcome.