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.
