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Acta Neurologica Belgica

, Volume 117, Issue 3, pp 753–755 | Cite as

Intravenous thrombolysis after reversal of dabigatran by idarucizumab: a moment to be a pioneer

  • G. TurineEmail author
  • A. Peeters
  • C. Hermans
  • S. Eeckhoudt
  • T. Duprez
Letter to the Editor

Introduction

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.

Case report

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...

Keywords

Ischemic stroke Intravenous thrombolysis Dabigatran Idarucizumab 

Notes

Compliance with ethical standards

Funding

None.

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.

Ethical approval

For this type of study formal consent is not required.

Informed consent

Informed consent was obtained from all participants included in the study.

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Copyright information

© Belgian Neurological Society 2017

Authors and Affiliations

  1. 1.Department of NeurologyCliniques Universitaires St-LucBrusselsBelgium
  2. 2.Haemostasis and Thrombosis Unit, Division HaematologyCliniques Universitaires LucBrusselsBelgium
  3. 3.Haemostasis and Thrombosis Laboratory, Department of Clinical BiologyCliniques Universitaires Saint-LucBrusselsBelgium
  4. 4.Neuroradiology Section, Department of RadiologyCliniques Universitaires UCL St-LucBrusselsBelgium

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