Branched endovascular aneurysm repair complicated by disseminated intravascular coagulation while using tocilizumab

Disseminated intravascular coagulation (DIC) has been reported as a complication following endovascular procedures. We present the case of a 69-year-old female with giant cell arteritis on tocilizumab therapy, who underwent a first-stage branched endovascular aneurysm repair for a Crawford type III thoracoabdominal aneurysm. Postoperatively, she developed DIC. After excluding other causes, we assumed endoleakage through the celiac branch combined with tocilizumab-induced hypofibrinogenemia as the primary cause. The second stage was expedited and tocilizumab discontinued. The DIC resolved within weeks. Although rare, hemostatic disbalances may occur after endovascular procedures. Tocilizumab might have facilitated the progression of DIC under these circumstances.