Cerebrovascular infarction following bilateral total knee arthroplasty and tranexamic acid administration.

Tranexamic acid has been shown to reduce perioperative blood loss without increasing the risk of venous thromboembolism after total knee replacement. However studies to date were designed to assess efficacy as the primary outcome and were not powered to assess safety. We report the case of a 65-year-old male with a previously undiagnosed patent foramen ovale who suffered pulmonary emboli and cerebrovascular infarction after synchronous bilateral total knee replacement during which tranexamic acid was administered intravenously.