Fatal massive intravascular coagulation during phlebography. Responsibility of epsilon-aminocaproic acid?
Coste, F.; Tremolières, F.; Bousquet, M.; Martin, E.; Dreyfuss, D.; Levesque, M.; Barge, J.
Presse Medicale 14(15): 832-834
1985
ISSN/ISBN: 0755-4982 PMID: 3158905 Document Number: 261015
The occurrence during phlebography of massive intravascular coagulation involving the inferior vena cava, the right cardiac cavities and the entire pulmonary arterial network suggested that epsilon-aminocaproic acid administered before phlebography was responsible for this complication. The mechanisms of reactions to contrast media are still poorly understood, but these reactions are known to include, in some cases, disseminated intravascular coagulation. This phenomenon was histologically demonstrated in our patient, and it may be suggested that its strong enhancement by the antifibrinolytic agent had resulted in the fatal accident. In view of the possibility of such lethal reactions, the advisability of administering epsilon-aminocaproic acid--a drug widely used in France for the prevention and treatment of contrast media reactions--should be reconsidered.