Topic Teaching: Intracranial hemorrhage post systemic thrombolysis in ischemic stroke patients - A focus on fibrinogen repletion

Presented by:

Dr. Isabelle Blais-Normandin
Transfusion Medicine Physician Trainee
University of British Columbia

Objectives:

1.    Explain the pathophysiology associated with bleeding post rt-PA.
2.    List the advantages and disadvantages of using fibrinogen concentrate or cryoprecipitate.
3.    Prescribe the initial treatment of an intracranial hemorrhage post-rt-PA.

References:

1.    Barra M, Feske S, Sylvester K and al. Fibrinogen concentrate for the treatment of thrombolysis-associated hemorrhage in adult ischemic stroke. Clinical and applied Thrombosis / Hemostasis. 2020: 20 ; 1-9
2.    Franchini M, Lippi G. Fibrinogen replacement therapy: a critical review of the literature. Blood Transf. 2012: 10 ; 23-27
3.    Yaghi S, Willey J, Cucchiara B and al. Treatment and outcome of hemorrhagic transformation after intravenous alteplase in acute ischemic stroke- A scientific statement for healthcare professionals from the American Heart Association and American stroke association. Stroke. 2017: 48;343-361
4.    Callum J, Farkouh M, Scales D and al. Effect of fibrinogen concentrate vs cryoprecipitate on blood component transfusion after cardiac surgery- The FIBRES randomized clinical trial. JAMA. 2019: 322(20); 1966-1976

Note: The session is a self-approved group learning activity (Section 1) as defined by the Maintenance of Certification program of The Royal College of Physicians and Surgeons of Canada.

To register for the LearnTransfusion series, send an email to learn.transfusion@blood.ca with  “Weekly Transfusion Medicine Seminars” in the subject line. Include your name and complete e-mail address in the body of the e-mail, and confirm that you would like to register for the LearnTransfusion series. You will then receive weekly email notifications of upcoming series events with details on how to join the webinars (e.g., call-in number and a link to register for the webinar).

The LearnTransfusion series is the seminar component of the Areas of Focused Competency (AFC)-Diploma Program in Transfusion Medicine. The series, organized by Canadian Blood Services is also open to all practitioners in the field of Transfusion Medicine. Through a series of regular webinars, trainees and practitioners are exposed to various scientific, technical and clinical aspects of transfusion medicine.