Does intravenous thrombolysis (IVT) compared to reversal agent use affect safety in patients with recent intake of direct oral anticoagulants?
Off-label intravenous thrombolysis appears safe in patients with recent direct oral anticoagulant intake, confirming prior observational data.
This target trial confirms previous observational data regarding the safety of off-label IVT in patients with recent DOAC intake. More data and dedicated trials are needed for patients with confirmed high DOAC plasma levels and regarding the efficacy and safety of DOAC reversal before IVT.
Meinel et al. (2025) studied this question.