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Indium 111-labeled platelets accumulation over abdominal aortic graft with chronic disseminated intravascular
T Kanda1, K Kaneko, Y Yamauchi
1Department of Internal Medicine, Takasaki National Hospital, Japan.
Insights
Aortic graft prostheses can cause chronic disseminated intravascular coagulation (DIC). Indium 111-labeled platelets scintigraphy aids detection, and low-dose heparin may be effective treatment for this localized DIC.
Area of Science:
- Vascular Surgery
- Hematology
- Diagnostic Imaging
Background:
- A seventy-six-year-old male presented with chronic disseminated intravascular coagulation (DIC) and renal dysfunction.
- The patient had a history of abdominal aortic aneurysm (AAA) treated with a Dacron graft prosthesis.
Abstract:
The authors describe a seventy-six-year-old man with aortic graft, which became the focus of chronic disseminated intravascular coagulation (DIC). The patient had abdominal aortic aneurysm (AAA) and the size had increased up to 38 mm in diameter. The AAA was excised and replaced by Dacron graft. Ten months later, the DIC became chronic with renal dysfunction. Indium 111-labeled platelets scintigraphy showed increased accumulation of radioactivity over the graft. In the treatment of chronic DIC, low-dose subcutaneous heparin injection (5,000-10,000/day) was effective, and he was discharged. In this case there was also suspicion of lung cancer and recurrent aortic aneurysm, which were a more reasonable cause of chronic DIC. This case suggests that an aortic graft prosthesis may be a cause of localized chronic DIC and that indium 111-labeled platelets scintigraphy is useful for the detection of localized chronic DIC. Moreover, subcutaneous heparin administration may be effective for chronic DIC in patients with an abdominal aortic graft prosthesis.