Tranexamic acid administration during orthopedic surgery may pose a risk of acute coronary thrombosis in high-risk patients with indwelling coronary stents.
Tranexamic acid (TXA), an antifibrinolytic, is routinely used to decrease transfusion rates in total joint replacement surgery. While recent publications have indicated a low risk of TXA-associated thromboembolic events in this orthopedic population, few studies specifically address the safety of TXA administration in high-risk patients. We present a case of acute coronary thrombus requiring emergent intervention in a patient with indwelling coronary stents who underwent shoulder arthroplasty with TXA administration.
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Bridges et al. (2017) studied this question.
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