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

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 thromb...

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Detalles Bibliográficos
Autores principales: Kafke, Waldemar, Kraft, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4945814/
https://www.ncbi.nlm.nih.gov/pubmed/27482196
http://dx.doi.org/10.1159/000447531
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author Kafke, Waldemar
Kraft, Peter
author_facet Kafke, Waldemar
Kraft, Peter
author_sort Kafke, Waldemar
collection PubMed
description 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.
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spelling pubmed-49458142016-08-01 Intravenous Thrombolysis after Reversal of Dabigatran by Idarucizumab: A Case Report Kafke, Waldemar Kraft, Peter Case Rep Neurol Case Report 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. S. Karger AG 2016-06-27 /pmc/articles/PMC4945814/ /pubmed/27482196 http://dx.doi.org/10.1159/000447531 Text en Copyright © 2016 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Case Report
Kafke, Waldemar
Kraft, Peter
Intravenous Thrombolysis after Reversal of Dabigatran by Idarucizumab: A Case Report
title Intravenous Thrombolysis after Reversal of Dabigatran by Idarucizumab: A Case Report
title_full Intravenous Thrombolysis after Reversal of Dabigatran by Idarucizumab: A Case Report
title_fullStr Intravenous Thrombolysis after Reversal of Dabigatran by Idarucizumab: A Case Report
title_full_unstemmed Intravenous Thrombolysis after Reversal of Dabigatran by Idarucizumab: A Case Report
title_short Intravenous Thrombolysis after Reversal of Dabigatran by Idarucizumab: A Case Report
title_sort intravenous thrombolysis after reversal of dabigatran by idarucizumab: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4945814/
https://www.ncbi.nlm.nih.gov/pubmed/27482196
http://dx.doi.org/10.1159/000447531
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