Intravenous Thrombolysis after Reversal of Dabigatran by Idarucizumab: A Case Report

Autor: Waldemar Kafke, Peter Kraft, Department of Neurology
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Zdroj: Case Reports in Neurology, Vol 8, Iss 2, Pp 140-144 (2016)
Druh dokumentu: article
ISSN: 1662-680X
DOI: 10.1159/000447531
Popis: We describe a 75-year-old female patient with nonvalvular atrial fibrillation who presented with acute ischemic stroke during treatment with dabigatran 2 × 110 mg per day. After informed consent, we reversed the anticoagulant effects of dabigatran using idarucizumab and applied an intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (off-label use). An intracerebral hemorrhage was excluded after systemic thrombolysis. Despite the IVT, the patient’s clinical condition deteriorated and she developed an ischemic lesion in the right pons, the right thalamus and right cerebellum. To date, the literature lacks data concerning the thrombolytic treatment of acute ischemic stroke in patients after specific reversal of the non-vitamin K oral anticoagulant dabigatran using idarucizumab. Given the rapid and sustainable efficacy of idarucizumab, the reversal of dabigatran followed by thrombolysis seems to be safe, but further studies and register data are still needed to confirm our preliminary observation, especially to provide additional data concerning the risk-benefit evaluation.
Databáze: Directory of Open Access Journals
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