{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T06:31:31Z","timestamp":1766557891124,"version":"3.44.0"},"reference-count":10,"publisher":"SMC Media","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Aortic dissection is a life-threatening cardiovascular emergency, particularly Stanford type A, which typically necessitates urgent surgical intervention. Despite advances in surgical techniques and perioperative care, preoperative bleeding and coagulopathy remain significant challenges. Tranexamic acid, an antifibrinolytic agent, is widely used to minimize perioperative bleeding in cardiovascular surgeries; however, its role in the non-surgical, preoperative stabilization of aortic dissection has not been well established. We present the case of a 56-year-old woman with a history of hypertension and dyslipidaemia who presented with sudden-onset, severe interscapular chest pain. Computed tomography angiography revealed an ascending aortic dissection. Initial management included intravenous labetalol for blood pressure and heart rate control, along with the administration of 1 gram of tranexamic acid. She was subsequently transferred for emergent surgical repair. Intraoperatively, however, no active aortic bleeding was identified. Instead, a clot was found sealing the dissected segment of the ascending aorta, effectively halting further propagation and haemorrhage. This unexpected finding led to the cancellation of surgical repair. We hypothesize that tranexamic acid contributed significantly to the formation of this stabilizing clot through its antifibrinolytic effects. The patient\u2019s clinical outcome was favourable, with no complications observed. This case highlights a novel potential application of tranexamic acid in the emergency management of aortic dissection. To our knowledge, this is the first reported case in which tranexamic acid contributed to spontaneous thrombus formation within a dissected aortic segment, preventing catastrophic haemorrhage and obviating the need for surgery.<\/jats:p>","DOI":"10.12890\/2025_005650","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T15:38:08Z","timestamp":1755531488000},"source":"Crossref","is-referenced-by-count":1,"title":["Spontaneous aortic sealing with tranexamic acid in type a dissection: a novel life-saving finding"],"prefix":"10.12890","volume":"12","author":[{"given":"Antonio","family":"Al Hazzouri","sequence":"first","affiliation":[{"name":"Department of Internal medicine, University of Balamand, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Attieh","sequence":"first","affiliation":[{"name":"Department of Internal medicine, University of Balamand, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karam","family":"Karam","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University of Balamand, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elias","family":"Fiani","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University of Balamand, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2025,8,18]]},"reference":[{"key":"10.12890\/2025_005650_ref1","doi-asserted-by":"crossref","unstructured":"Writing Committee Members; Isselbacher EM, Preventza O, Hamilton Black J 3rd, Augoustides JG, Beck AW, et al. 2022 ACC\/AHA guideline for the diagnosis and management of aortic disease: A report of the American Heart Association\/American College of Cardiology Joint Committee on Clinical Practice Guidelines. J Thorac Cardiovasc Surg 2023;166:e182-e331. doi: 10.1016\/j.jtcvs.2023.04.023","DOI":"10.1016\/j.jtcvs.2023.04.023"},{"key":"10.12890\/2025_005650_ref2","doi-asserted-by":"crossref","unstructured":"Mazzolai L, Teixido-Tura G, Lanzi S, Boc V, Bossone E, Brodmann M, et al. 2024 ESC Guidelines for the management of peripheral arterial and aortic diseases. Eur Heart J 2024;45:3538-3700. doi: 10.1093\/eurheartj\/ehae179","DOI":"10.1093\/eurheartj\/ehae179"},{"key":"10.12890\/2025_005650_ref3","doi-asserted-by":"crossref","unstructured":"Kanamoto R, Oda T, Akaiwa K, Nakamura K, Tayama E. Total arch replacement for the enhanced-fibrinolytic-type disseminated intravascular coagulation patient with endoleak after thoracic endovascular aortic repair for aortic dissection. Gen Thorac Cardiovasc Surg Cases 2023;2:34. doi: 10.1186\/s44215-023-00046-1","DOI":"10.1186\/s44215-023-00046-1"},{"key":"10.12890\/2025_005650_ref4","doi-asserted-by":"crossref","unstructured":"Erdoes G, Ahmed A, Kurz SD, Gerber D, Bolliger D. Perioperative hemostatic management of patients with type A aortic dissection. Front Cardiovasc Med 2023;10:1294505. doi: 10.3389\/fcvm.2023.1294505","DOI":"10.3389\/fcvm.2023.1294505"},{"key":"10.12890\/2025_005650_ref5","doi-asserted-by":"crossref","unstructured":"Clothier JS, Kobsa S. Management of Acute Type A Aortic Dissection. Cardiol Clin 2025;43:261-277. doi: 10.1016\/j.ccl.2025.01.003","DOI":"10.1016\/j.ccl.2025.01.003"},{"key":"10.12890\/2025_005650_ref6","doi-asserted-by":"crossref","unstructured":"Yuan X, Mitsis A, Mozalbat D, Nienaber CA. Alternative management of proximal aortic dissection: concept and application. Indian J Thorac Cardiovasc Surg 2022;38:183-192. doi: 10.1007\/s12055-021-01281-3","DOI":"10.1007\/s12055-021-01281-3"},{"key":"10.12890\/2025_005650_ref7","doi-asserted-by":"crossref","unstructured":"Casati V, Sandrelli L, Speziali G, Calori G, Grasso MA, Spagnolo S. Hemostatic effects of tranexamic acid in elective thoracic aortic surgery: a prospective, randomized, double-blind, placebo-controlled study. J Thorac Cardiovasc Surg 2002;123:1084-1091. doi: 10.1067\/mtc.2002.120717","DOI":"10.1067\/mtc.2002.120717"},{"key":"10.12890\/2025_005650_ref8","doi-asserted-by":"crossref","unstructured":"Zhang B, He L, Yao YT. Evidence In Cardiovascular Anesthesia (Eica) Group, Intravenous Tranexamic Acid Reduces Post-Operative Bleeding and Blood Transfusion in Patients Undergoing Aortic Surgery: A PRISMA-Compliant Systematic Review and Meta-Analysis. Rev Cardiovasc Med 2023;24:120. https:\/\/doi.org\/10.31083\/j.rcm2404120","DOI":"10.31083\/j.rcm2404120"},{"key":"10.12890\/2025_005650_ref9","doi-asserted-by":"crossref","unstructured":"Ahn KT, Yamanaka K, Iwakura A, Hirose K, Nakatsuka D, Kusuhara T, et al. Usefulness of intraoperative continuous infusion of tranexamic acid during emergency surgery for type A acute aortic dissection. Ann Thorac Cardiovasc Surg 2015;21:66-71. doi: 10.5761\/atcs.oa.13-00339","DOI":"10.5761\/atcs.oa.13-00339"},{"key":"10.12890\/2025_005650_ref10","doi-asserted-by":"crossref","unstructured":"Guo J, Cao L, Wang H, Liu G, Zhou Y, Yang L, et al. High-Dose Tranexamic Acid in Patients Underwent Surgical Repair of Aortic Dissection Might Reduce Postoperative Blood Loss: A Cohort Analysis. Front Surg 2022;9:898579. doi: 10.3389\/fsurg.2022.898579","DOI":"10.3389\/fsurg.2022.898579"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/5650\/4785","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/5650\/4786","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/5650\/4786","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T12:44:13Z","timestamp":1756903453000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/5650"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,18]]},"references-count":10,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.12890\/2025_005650","relation":{"has-manifestation":[{"id-type":"other","id":"1-129-5650-g4785","asserted-by":"subject"},{"id-type":"other","id":"1-129-5650-g4786","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-129","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"type":"electronic","value":"2284-2594"}],"subject":[],"published":{"date-parts":[[2025,8,18]]}}}