Thrombolysis in Acute Ischemic Stroke after Idarucizumab for Dabigatran Etexilate Reversal in Elderly: A Case Report.

Journal of vascular and interventional neurology Pub Date : 2018-11-01

Antonio Baule, Federico Cabigiosu, Bastianina Zanda, Alessandra Sanna, Claudia Mongili, Antonio Manca

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Abstract

Introduction: Dabigatran is one of the nonvitamin K antagonist oral anticoagulants. Thrombolytic treatment with intravenous recombinant tissue plasminogen activator is contraindicated in patients taking a DOAC. Idarucizumab was recently approved for dabigatran-activity reversing in severe bleeding, emergency surgery, or urgent procedures, but many attempts have been made to use idarucizumab in patients presenting with acute ischemic stroke in order to be eligible for thrombolysis.

Case: Our patient was an 89-year-old woman with severe aphasia who was treated with dabigatran for nonvalvular atrial fibrillation. She received an infusion of idarucizumab followed by thrombolytic therapy, with complete remission of symptoms after 24 hours.

Discussion: Idarucizumab is a safe option for patients with acute ischemic stroke treated with dabigatran; otherwise eligibles for thrombolysis, even in very old people like our patient.

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依达鲁珠单抗治疗老年达比加群酯逆转后急性缺血性卒中的溶栓:一例报告。

达比加群是一种非维生素K拮抗剂口服抗凝剂。静脉注射重组组织型纤溶酶原激活剂溶栓治疗是服用DOAC患者的禁忌。Idarucizumab最近被批准用于严重出血、急诊手术或紧急手术的达比加群活性逆转，但许多人试图将Idarucizumab用于急性缺血性卒中患者，以便符合溶栓条件。病例:我们的患者是一名患有严重失语的89岁女性，她因非瓣膜性心房颤动而接受达比加群治疗。她接受了依达鲁珠单抗输注，随后进行了溶栓治疗，24小时后症状完全缓解。讨论:Idarucizumab是达比加群治疗急性缺血性卒中患者的安全选择;否则可以进行溶栓治疗，即使是像我们的病人这样的老年人。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Journal of vascular and interventional neurology

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