22 March 2026
: Case report 
Therapeutic Plasma Exchange for Uncontrollable Bleeding After Platelet Inhibition with Ticagrelor: A Report of 2 Cases
Unusual clinical course, Management of emergency care
Amanda Herrmann ABCDEF 1, Brenda Mai
ABCDEF 1, Yu Bai E 2, Brian Castillo E 3, Biswajit Kar E 4, Kimberly Klein E 5, Ismael A. Salas de Armas E 4, Eric Salazar E 6, Hlaing Tint ABCDEFG 1, Igor D. Gregoric E 4*
DOI: 10.12659/AJCR.950336
Am J Case Rep 2026; 27:e950336
Table 1 Case timelines.
| CASE #1: A 52-year-old man presenting to the ED with STEMI | CASE #2: A 66-year-old man presenting with unstable angina due to severe coronary artery disease | |||
|---|---|---|---|---|
| 2 PRU after surgery | ||||
| TPE performed (approx. 24 h after ticagrelor dose) | ||||
| 234 PRU | ||||
| 82 PRU | ||||
| Discharged with stable Hb 10.2 g/dL | ||||
| Care withdrawn | ||||
| ED – emergency department; STEMI – ST-elevation myocardial infarction; DAPT – dual antiplatelet therapy; VSD – ventricular septal defect; PCI – percutaneous coronary intervention; CABG – coronary artery bypass grafting; TPE – therapeutic plasma exchange. | ||||