Intravenous thrombolysis after reversal of dabigatran by idarucizumab: a moment to be a pioneer
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Effective anticoagulation is a contraindication for intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA). We here report our first and successful experience of systemic thrombolysis a few minutes after reversal of dabigatran by idarucizumab.
A 85-year-old, right-handed woman patient with a history of atrial fibrillation, arterial hypertension, dyslipidemia, and a recent transient ischemic attack was admitted to the Emergency Department at 7.15 AM. At 3.00 AM, she had awakened, time we took as ‘last known well’. Her husband noted then she had forgotten to take the evening dose of dabigatran 110 mg, which he immediately gave her. At 5.00 AM, he observed a right facial palsy. As symptoms did not resolve spontaneously, he called the emergency medical service. On admission, blood pressure was 170/100 mmHg, glycemia was 176 mg/dL, and cardiac rate was 98, irregular. Neurological examination showed drowsiness, a right-sided paresis of...
KeywordsIschemic stroke Intravenous thrombolysis Dabigatran Idarucizumab
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Conflict of interest
Gaëtane Turine declares that she has no conflict of interest. André Peeters has received a speaker honorarium of Boehringer-Ingelheim. Cédric Hermans has received a speaker honorarium of Boehringer-Ingelheim. Stéphane Eeckhoudt declares he has no conflict of interest. Thierry Duprez declares that he has no conflict of interest.
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