Intravenous thrombolysis for stroke after Dabigatran reversal with Idarucizumab: an update
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Safety of intravenous thrombolysis (IVT) for ischemic stroke in patients under direct oral anticoagulant (DOAC) treatment is an even dilemma. Until there are no established cut-off values for specific tests that are able to alert clinicians to bleeding risk of IV recombinant tissue plasminogen activator (rt-PA), IVT is discouraged in stroke patients receiving DOAC <24–48 h . Mechanical recanalization may be considered as an alternative treatment option for stroke related to large vessel occlusion . Although half-life of DOAC is short, the rapid antagonization of the anticoagulant effect before IVT may be a new strategy. Among all DOACs, only Dabigatran currently has a specific and approved antidote for use during emergency situations when there is a need to reverse the anticoagulant effects. Idarucizumab is a humanized monoclonal antibody fragment that binds Dabigatran and irreversibly neutralizes the anticoagulant effect; the effect of Idarucizumab is extremely...
KeywordsStroke Patient Dabigatran Alteplase Anticoagulant Effect Intravenous Thrombolysis
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Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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