Successful intravenous thrombolysis in acute ischemic stroke after reversal of dabigatran etexilate with idarucizumab at the end of therapeutic time window

Gorana Vukorepa; Sabina Deveđija; Miljenko Crnjaković; Mirna Karakaš; Željka Ćuk

doi:10.4103/2452-2473.285015

Successful intravenous thrombolysis in acute ischemic stroke after reversal of dabigatran etexilate with idarucizumab at the end of therapeutic time window

Turk J Emerg Med. 2020 May 27;20(2):90-92. doi: 10.4103/2452-2473.285015. eCollection 2020 Apr-Jun.

Authors

Gorana Vukorepa¹, Sabina Deveđija¹, Miljenko Crnjaković¹, Mirna Karakaš¹, Željka Ćuk¹

Affiliation

¹ Department of Neurology, University Hospital Dubrava, Zagreb, Croatia.

Abstract

Dabigatran is a direct oral anticoagulant that is widely used for stroke prevention in patients with atrial fibrillation. We report a case of an 80-year-old stroke patient on dabigatran for permanent atrial fibrillation, who presented with an initial National Institutes of Health Stroke Scale (NIHSS) of 8. Dabigatran was reversed with idarucizumab, and intravenous tissue-type plasminogen activator (IV-tPA) was administrated beginning 4 h and 28 min after the symptom onset. The patient was discharged with an NIHSS of 1. Our case is an additional proof of safety and efficiency of idarucizumab in the clinical setting of ischemic stroke before the administration of IV-tPA.

Keywords: Acute ischemic stroke; acute stroke therapy; anticoagulants; dabigatran; idarucizumab; thrombolysis.

Publication types

Case Reports