title: Lingual Haematoma due to Tenecteplase in a Patient with Acute Myocardial Infarction.
abstract: The use of intravenous thrombolytic agents has revolutionised the treatment of acute myocardial infarction. However, the improvement in mortality rate achieved with these drugs is tempered by the risk of serious bleeding complications, including intracranial haemorrhage. Tenecteplase is a genetically engineered mutant tissue plasminogen activator. Haemorrhagic complications of tissue plasminogen activator (tPA) are well known. Compared to other tPAs, tenecteplase use leads to lower rates of bleeding complications. Here, we report a case of unusual site of spontaneous bleeding, intralingual haematoma during tenecteplase therapy following acute myocardial infarction, which caused significant upper airway obstruction and required tracheotomy to maintain the patient's airway. Clinical dilemmas related to securing the airway or reversing the effects of tissue plasminogen activator are discussed.
authors.affiliation: Sinop Atatürk Government Hospital, Otorhinolaryngology Department, 57000 Sinop, Turkey ; Kaptanpaşa Mahallesi Halit Ziya Türkkan Caddesi, Middleist Blokları A Blok No. 10-12 D:25, Okmeydanı, 34384 İstanbul, Turkey.
authors.forename: Muhlis
authors.initials: M
authors.lastname: Bal
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Atar
authors.forename: Ziya
authors.initials: Z
authors.lastname: Salturk
authors.forename: Ahmet Hakan
authors.initials: AH
authors.lastname: Ateş
authors.forename: Serkan
authors.initials: S
authors.lastname: Yağcı
authors.forename: Gökçen
authors.initials: G
authors.lastname: Coşkun Bal