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REAL WORLD MANAGEMENT OF BLEEDING POST-TPA IN ACUTE ISCHEMIC STROKE

Nicole M. Acquisto

Management of bleeding following thrombolysis (t-PA) for ischemic stroke includes discontinuing t-PA, noncontrast head CT, CBC, PT/INR, aPTT, and fibrinogen with supportive care and possible cryoprecipitate, platelets, tranexamic acid (TXA) or aminocaproic acid administration.  National guidelines offer insight, without clear recommendations related to timing/sequence of therapies.  Evidence-based guidelines for bleeding within 12 hours of t-PA with sequential recommendations for laboratory testing, empiric cryoprecipitate, and blood product/medication treatment were developed.  We sought to evaluate bleeding complications following t-PA administration and guideline use at a large academic medical center.