Acute arterial thrombosis associated with inadvertent high dose of tranexamic acid

Surjya Prasad Upadhyay; Piyush N. Mallick; Manish Jagia; Raj Kumar A. Singh

doi:10.4103/0972-5229.118443

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Acute arterial thrombosis associated with inadvertent high dose of tranexamic acid

Surjya Prasad Upadhyay, Piyush N. Mallick, Manish Jagia, Raj Kumar A. Singh

Keywords : Arterial thrombosis, hemorrhage control, thrombo-embolism, tranexamic acid

Citation Information : Upadhyay SP, Mallick PN, Jagia M, Singh RK. Acute arterial thrombosis associated with inadvertent high dose of tranexamic acid. Indian J Crit Care Med 2013; 17 (4):237-239.

DOI: 10.4103/0972-5229.118443

License: CC BY-ND 3.0

Published Online: 01-08-2013

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Abstract

Tranexamic acid (TA) act as anti-fibrinolytic agent and is widely used to limit bleeding in clinical practice. Tranexemic acid bind with plasminogen and prevent its conversion to plasmin, which limits the fibrinolytic pathway, so there is a theoretical risk of increasing thrombosis with high or prolonged therapy with TA. We encountered a case of acute arterial thrombosis following inadvertent administration of high dose of TA. A 27-years-old male with no other co-morbidity was ordered intravenous 1 gm TA to control excessive bleeding from previous bladder injury, but by mistake, he received 10 gm of TA. The patient developed signs and symptoms of acute ischemia in the right lower limb, which was diagnosed as acute iliac arterial thrombosis by computed tomography (CT) angiography. The patient was managed with systemic heparinization, fasciotomy for impending gangrene and other supportive care following which he recovered fully within a few days. Caution should be exercised for all prophylactic use, especially with high dosage or prolonged therapy with TA.

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