scholarly journals Successful thrombolysis for acute ischaemic stroke after reversal of dabigatran etexilate with idarucizumab

2019 ◽  
Vol 12 (5) ◽  
pp. e229128
Author(s):  
Chee Hoou Loh ◽  
Geoffrey Herkes
Keyword(s):  
Atrial Fibrillation ◽  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Dabigatran Etexilate ◽  
Cerebellar Stroke ◽  
Systemic Thrombolysis ◽  
Novel Treatment ◽  
Successful Thrombolysis

We report the experience of reversing dabigatran prior to administering systemic thrombolysis for acute ischaemic cerebellar stroke, which was well tolerated with no haemorrhagic complications after thrombolysis. Given the increasingly common use of dabigatran for atrial fibrillation, the use of idarucizumab to reverse of dabigatran is a novel treatment that should be considered as an important adjunct to facilitate thrombolysis for ischaemic strokes and minimise haemorrhagic complications.

Successful thrombolysis in essential thrombocythemia-related acute ischaemic stroke

2021 ◽  
Vol 14 (5) ◽  
pp. e242925
Author(s):  
Ishita Desai ◽  
Ashutosh Tiwari ◽  
Mritunjai Kumar Singh ◽  
Niraj Kumar
Keyword(s):  
Ischaemic Stroke ◽  
Essential Thrombocythemia ◽  
Acute Ischaemic Stroke ◽  
Jak2 V617f ◽  
Preliminary Evidence ◽  
Sudden Onset ◽  
Left Ventricular ◽  
Interesting Case ◽  
Increased Risk ◽  
Successful Thrombolysis

Essential thrombocythemia (ET)-related acute ischaemic stroke (AIS) may account for approximately 0.25%–0.5% of all ischaemic strokes. If left undiagnosed and untreated, patients with ET carry an increased risk of recurrent thrombosis involving major organs including the brain. We report an interesting case of a 67-year-old man, who was successfully thrombolysed for AIS resulting from ET. He presented with sudden onset of left-sided hemiparesis with a left-ventricular clot. His subsequent investigations including positive JAK2 V617F mutation confirmed the diagnosis of ET. He made a significant recovery with thrombolysis, anticoagulation, antiplatelet and hydroxyurea. A fear of post-thrombolytic haemorrhagic complications appears the major reason for the lack of reports of thrombolysis in ET-related AIS. Although the diagnosis of ET was confirmed on subsequent investigations, successful thrombolysis in our case provides preliminary evidence that ET-related AIS cases can undergo successful thrombolysis using tenecteplase. To date, ours is only the second case of ET-related AIS being thrombolysed.

Endovascular thrombectomy in patients with acute ischaemic stroke and atrial fibrillation: a MR CLEAN subgroup analysis

2017 ◽  
Vol 13 (8) ◽  
pp. 996-1002 ◽  
Author(s):  
Alis Heshmatollah ◽  
Puck Fransen ◽  
Olvert Berkhemer ◽  
Debbie Beumer ◽  
Aad van der Lugt ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Subgroup Analysis ◽  
Endovascular Thrombectomy ◽  
Mr Clean

Acute Ischaemic Stroke and Atrial Fibrillation—Does Time, Location and Severity Matter?

2008 ◽  
Vol 17 ◽  
pp. S86-S87
Author(s):  
Martin Brown ◽  
William O’Brien ◽  
Tommy Wong ◽  
Maged Willaim ◽  
Scott Whyte ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke

Timing of anticoagulation therapy in patients with acute ischaemic stroke and atrial fibrillation

2016 ◽  
Vol 116 (09) ◽  
pp. 410-416 ◽  
Author(s):  
Maurizio Paciaroni ◽  
Giancarlo Agnelli ◽  
Walter Ageno ◽  
Valeria Caso
Keyword(s):  
Atrial Fibrillation ◽  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Substantial Reduction ◽  
Anticoagulation Therapy ◽  
Early Recurrence ◽  
Optimal Time ◽  
Optimal Timing ◽  
Stroke Patients ◽  
Haemorrhagic Transformation

SummaryIn patients with acute stroke and atrial fibrillation (AF), the risk of early recurrence has been reported to range between 0.1% and 1.3% per day. Anticoagulants are the most effective therapy for the prevention of recurrent ischaemic stroke in these patients, but randomised clinical trials have failed to produce any evidence supporting the administration of heparin within 48 hours from stroke onset as it has been associated with a non-significant reduction in the recurrence of ischaemic stroke, no substantial reduction in death and disability, and an increase in intracranial bleeding. As early haemorrhagic transformation is a major concern in the acute phase of stroke patients with AF, determining the optimal time to start anticoagulant therapy is essential. This review which focuses on the epidemiology of recurrent ischaemic stroke and haemorrhagic transformation in patients with acute ischaemic stroke and AF, proposes a model for decision making on optimal timing for initiating anticoagulation, based on currently available evidence.

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