title: Lack of Effect of Platelet Transfusions and Desmopressin on Intracranial Bleeding in a Patient Receiving Ticagrelor.
abstract: We describe a case of a 67-year-old man who required emergency surgery for acute intracranial bleeding after having received a loading dose of aspirin and ticagrelor for an acute ST-elevation myocardial infarction. Before and during the craniocervical decompression, the assessment of platelet function was performed using the Multiplate® analyzer. Biological evaluation of platelet function was consistent with the clinical impression, suggesting that platelet transfusion and desmopressin administration in the presence of ticagrelor had very little, if any, hemostatic effect.
authors.affiliation: From the *Division of Anaesthesiology, University Hospitals of Geneva, Geneva, Switzerland; and †Division of Angiology and Haemostasis, Geneva University Hospitals, Geneva Platelet Group, Faculty of Medicine, Geneva, Switzerland.
authors.forename: Julien
authors.initials: J
authors.lastname: Maillard
authors.forename: Vanessa
authors.initials: V
authors.lastname: Cartier Faessler
authors.forename: Pierre
authors.initials: P
authors.lastname: Fontana
authors.forename: Fanny
authors.initials: F
authors.lastname: Bonhomme
mesh_terms: D000241:Adenosine / Q000009:adverse effects / Q000031:analogs & derivatives*; D000368:Aged; D001241:Aspirin / Q000009:adverse effects; D003131:Combined Modality Therapy; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage*; D017809:Fatal Outcome; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology / Q000628:therapy*; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy; D015539:Platelet Activation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D010979:Platelet Function Tests; D017713:Platelet Transfusion; D058921:Purinergic P2Y Receptor Antagonists / Q000009:adverse effects; D000077486:Ticagrelor
chemical_list: D006490:Hemostatics; D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D003894:Deamino Arginine Vasopressin; D000077486:Ticagrelor; D000241:Adenosine; D001241:Aspirin