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Tranexamic acid for epistaxis

Justin Morgenstern, Sahaana Rangarajan, Corey Heitz, Chris Bond, William K Milne
No abstract text is available yet for this article.
April 6, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Asha R Birmingham, Nathan D Mah, Ran Ran, Matthew Hansen
OBJECTIVE: To evaluate the effectiveness and potential benefits of topical tranexamic acid (TXA) in the management of acute epistaxis. METHODS: Retrospective review was performed among all patients presenting to the institution's emergency department (ED) with epistaxis between September 2014 and August 2016. Patients achieving hemostasis with standard of care agents, such as oxymetazoline, lidocaine, or epinephrine were excluded. The primary outcome was the ED length of stay (LOS)...
March 21, 2018: American Journal of Emergency Medicine
Michael S Runyon
No abstract text is available yet for this article.
March 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Ashleigh A Halderman, Matthew W Ryan, Christopher Clark, Raj Sindwani, Douglas D Reh, David M Poetker, Rosangela Invernizzi, Bradley F Marple
BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant hereditary disorder resulting in vascular dysplasia and formation of arteriovenous malformations. Recurrent epistaxis is a hallmark of the disease. An array of medical therapies are used in this patient population, but robust evidence-based recommendations regarding the medical treatment of epistaxis are lacking. This systematic review was performed to look at the current literature and make meaningful evidence-based recommendations...
February 2, 2018: International Forum of Allergy & Rhinology
Getaw Worku Hassen, Paula Clemons, Michelle Kaplun, Hossein Kalantari
Epistaxis is a well-known problem that is mostly self-limited. In certain cases it requires packing or cauterization. Tranexamic acid has been tried and has shown promising results. Here we report a case of prolonged epistaxis in a patient on dual anti-platelet agent therapy.
April 2018: American Journal of Emergency Medicine
Reza Zahed, Mohammad Hossain Mousavi Jazayeri, Asieh Naderi, Zeinab Naderpour, Morteza Saeedi
OBJECTIVE: We evaluated the efficacy of topical application of the injectable form of tranexamic acid (TXA) compared with anterior nasal packing (ANP) for the treatment of epistaxis in patients taking antiplatelet drugs (aspirin, clopidogrel, or both) who presented to the emergency department (ED). METHODS: A randomized, parallel-group clinical trial was conducted at two EDs. A total of 124 participants were randomized to receive topical TXA (500 mg in 5 mL) or ANP, 62 patients per group...
March 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
L Robard, J Michel, V Prulière Escabasse, E Bequignon, B Vérillaud, O Malard, L Crampette
OBJECTIVES: The authors present the guidelines of the French Oto-Rhino-Laryngology - Head and Neck Surgery Society (Société Française d'Oto-Rhino-Laryngologie et de Chirurgie de la Face et du Cou: SFORL) concerning specific treatment of epistaxis in Rendu-Osler-Weber disease. METHODS: A multidisciplinary work-group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience...
February 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
Jill K Logan, Hardin Pantle
PURPOSE: The role of topical tranexamic acid in the management of anterior epistaxis in adult patients in the emergency department (ED) is examined. SUMMARY: The use of alternative agents for the treatment of epistaxis before the use of nasal packing may be reasonable due to patient discomfort, potential complications, and the need for follow-up with a healthcare provider for packing removal. One such agent is tranexamic acid. Two published studies evaluated the off-label use of topical tranexamic acid for the treatment of epistaxis...
November 1, 2016: American Journal of Health-system Pharmacy: AJHP
Kevin J Whitehead, Nathan B Sautter, Justin P McWilliams, Murali M Chakinala, Christian A Merlo, Maribeth H Johnson, Melissa James, Eric M Everett, Marianne S Clancy, Marie E Faughnan, S Paul Oh, Scott E Olitsky, Reed E Pyeritz, James R Gossage
IMPORTANCE: Epistaxis is a major factor negatively affecting quality of life in patients with hereditary hemorrhagic telangiectasia (HHT; also known as Osler-Weber-Rendu disease). Optimal treatment for HHT-related epistaxis is uncertain. OBJECTIVE: To determine whether topical therapy with any of 3 drugs with differing mechanisms of action is effective in reducing HHT-related epistaxis. DESIGN, SETTING, AND PARTICIPANTS: The North American Study of Epistaxis in HHT was a double-blind, placebo-controlled randomized clinical trial performed at 6 HHT centers of excellence...
September 6, 2016: JAMA: the Journal of the American Medical Association
K M Musgrave, J Powell
There is limited guidance available to clinicians regarding the management of antithrombotic therapy during epistaxis, whilst there has been an increase in the use of anticoagulation and antiplatelet therapy. In addition, the introduction of direct oral anticoagulants (DOACs), such as dabigatran and rivaroxaban, over the last decade has significantly increased the complexity of managing the anticoagulated epistaxis patient. We undertook a systemic literature review investigating potential management strategies for each class of anti-thrombotic therapy during epistaxis...
December 1, 2016: Rhinology
Giorgia Saccullo, Mike Makris
Although in most cases von Willebrand disease (VWD) is a mild disorder, a subgroup of patients experience frequent bleeding. In contrast to severe hemophilia in which prophylaxis is the accepted standard of care, this is less frequently used in VWD. Most type 1 VWD patients can be adequately managed with episodic desmopressin and tranexamic acid. In patients with more severe disease, especially those with type 3 VWD, joint bleeds, epistaxis, menorrhagia, and gastrointestinal bleeding are problematic and usually require treatment with von Willebrand factor/factor VIII (VWF/FVIII) concentrate...
July 2016: Seminars in Thrombosis and Hemostasis
Joan Chepkorir Kiyeng, Abraham Siika, Cornelius Koech, Gerald S Bloomfield
BACKGROUND: Hereditary hemorrhagic telangiectasia is a rare autosomal dominant inherited disease characterized by vascular dysplasia. To the best of our knowledge, we report the first case in the literature of definite hereditary hemorrhagic telangiectasia diagnosed in western Kenya, a resource-limited setting with limited treatment options. CASE PRESENTATION: A 60-year-old black Kenyan woman was admitted 1 year ago to a hospital in western Kenya with an 11-year history of recurrent spontaneous epistaxis...
May 25, 2016: Journal of Medical Case Reports
Y Kamhieh, H Fox
BACKGROUND: The role of tranexamic acid in the management of epistaxis remains unclear. There is uncertainty about its safety and about the contraindications for its use. We performed a systematic review of the use of systemic and topical tranexamic acid in epistaxis and a comparative review of its use in other specialties. OBJECTIVE OF REVIEW: This review assesses and summarises the existing evidence for the efficacy and safety of tranexamic acid in the management of epistaxis...
December 2016: Clinical Otolaryngology
S Jervis, T Saunders, J Belcher, D Skinner
No abstract text is available yet for this article.
April 2017: Clinical Otolaryngology
David Clinkard, David Barbic
CLINICAL QUESTION: Does the application of topical tranexamic acid reduce bleeding as compared to anterior packing? ARTICLE CHOSEN: Zahed R, Moharamzadeh P, Alizadeharasi S, et al. A new and rapid method for epistaxis treatment using injectable form of tranexamic acid topically: a randomized controlled trial. Am J Emerg Med 2013;31(9):1389-92. OBJECTIVES: To determine if topically applied tranexamic acid reduces bleeding time in epistaxis...
January 2016: CJEM
L A Valentino, P A Holme
Inhibitor development in haemophilia patients is challenging especially when undergoing surgical procedures. The development of an inhibitor precludes using factor VIII (FVIII) therapy thereby requiring a bypassing agent (BPA) for surgical bleeding prophylaxis if the FVIII inhibitor titre >5 BU. Concomitant use of anti-inhibitor coagulant complex (AICC) and tranexamic acid has been reported in the literature as a beneficial treatment for this population. Anti-inhibitor coagulant complex is known to cause an increase in thrombin generation and tranexamic acid inhibits fibrinolysis...
November 2015: Haemophilia: the Official Journal of the World Federation of Hemophilia
Nusrat Zaffar, Tharsha Ravichakaravarthy, Marie E Faughnan, Nadine Shehata
The anti-fibrinolytic agent tranexamic acid (TXA) has been used to reduce bleeding in patients with hereditary hemorrhagic telangiectasia (HHT); however, there are limited data on its efficacy and safety. We conducted a retrospective study at the HHT center, using a structured questionnaire and data abstraction to determine the safety and effectiveness of TXA. Forty-two patients from the HHT database with a definite clinical or genetic diagnosis of HHT with epistaxis and/or gastrointestinal bleeding and receiving TXA were included, and their Epistaxis Severity Score (ESS), blood transfusions, and hospitalizations prior to and during TXA use were assessed...
January 2015: Annals of Hematology
S Gaillard, S Dupuis-Girod, F Boutitie, S Rivière, S Morinière, P-Y Hatron, G Manfredi, P Kaminsky, A-L Capitaine, P Roy, F Gueyffier, H Plauchu
BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is a genetic disorder associated with abnormal angiogenesis and disabling epistaxis. Tranexamic acid (TA) has been widely used in the treatment of these severe bleeds but with no properly designed trial. OBJECTIVES: To demonstrate the efficacy of TA in epistaxis in HHT patients and to explore its safety of use. PATIENTS/METHODS: A randomized, placebo-controlled, double-blind, cross-over trial was conducted...
September 2014: Journal of Thrombosis and Haemostasis: JTH
P J Robb
BACKGROUND: Tranexamic acid is a synthetic antifibrinolytic drug. It has been widely available for over 40 years, but only recently has it started to be used routinely in many surgical disciplines. For ENT surgeons, epistaxis and post-tonsillectomy bleeding contribute a significant proportion of the morbidity and emergency workload in a general ENT department. Published evidence indicates a potentially helpful role for tranexamic acid in managing epistaxis. RESULTS AND CONCLUSION: To date, the benefits of tranexamic acid as a prophylactic treatment to reduce the rate and severity of post-tonsillectomy bleeding are less certain...
July 2014: Journal of Laryngology and Otology
Urban W Geisthoff, Ulrich T Seyfert, Marcus Kübler, Birgitt Bieg, Peter K Plinkert, Jochem König
INTRODUCTION: Epistaxis is the most frequent manifestation in hereditary hemorrhagic telangiectasia, in which no optimal treatment exists. It can lead to severe anemia and reduced quality of life. Positive effects of tranexamic acid, an antifibrinolytic drug, have been reported on epistaxis related to this disorder. We sought to evaluate the efficacy of treating nosebleeds in hereditary hemorrhagic telangiectasia with tranexamic acid. MATERIALS AND METHODS: In a randomized, double-blind, placebo controlled, cross-over phase IIIB study, 1 gram of tranexamic acid or placebo was given orally 3 times daily for 3 months for a total of 6 months...
September 2014: Thrombosis Research
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