Splenic Artery Embolization for Treatment of Iatrogenic Kasabach-Merritt Phenomenon Following Failed Endovascular Splenic Artery Aneurysm Repair

Vasc Endovascular Surg. 2021 Oct;55(7):741-743. doi: 10.1177/15385744211003470. Epub 2021 Apr 13.

Abstract

Stent grafts are utilized to treat and exclude visceral arterial aneurysms while preserving flow through the vessel. Stent-associated thrombocytopenia is a rare complication not typically seen with modern stents. The following case describes the clinical presentation of stent kinking and consumptive coagulopathy. Stent-associated microangiopathic hemolytic anemia was inferred from protracted workup and exclusion of alternative diagnoses. Despite the risk of arterial puncture in the setting of profound thrombocytopenia, the patient was successfully treated with stent embolization with near immediate rebound in platelet count. This case report documents the presentation of rare stent-associated thrombocytopenia leading to challenging diagnostic evaluation and necessitating high-risk intervention.

Keywords: consumptive coagulopathy; microangiopathic hemolytic anemia; stent kinking; thrombocytopenia.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anemia, Hemolytic / etiology
  • Aneurysm / diagnostic imaging
  • Aneurysm / therapy*
  • Embolization, Therapeutic*
  • Endovascular Procedures / adverse effects*
  • Endovascular Procedures / instrumentation*
  • Humans
  • Iatrogenic Disease*
  • Kasabach-Merritt Syndrome / diagnostic imaging
  • Kasabach-Merritt Syndrome / etiology
  • Kasabach-Merritt Syndrome / therapy*
  • Male
  • Splenic Artery* / diagnostic imaging
  • Stents*
  • Thrombocytopenia / etiology
  • Treatment Outcome