Why the study?
Does idarucizumab reversal of dabigatran allow for safe administration of tPA in acute ischemic stroke?
Does idarucizumab reversal of dabigatran allow for safe administration of tPA in acute ischemic stroke?
Idarucizumab can safely reverse dabigatran to allow for subsequent tPA administration in acute ischemic stroke.
This case suggests feasibility of idarucizumab before tPA after dabigatran; hypothesis-generating and requires prospective confirmation before practice change.
Much excitement has been generated with the approval of idarucizumab, a humanized monoclonal antigen-binding antibody fragment that is capable of reversing the anticoagulant activity of dabigatran. Here, we describe our initial experience of using tissue plasminogen activator (tPA) in an acute posterior circulation ischemic stroke after dabigatran reversal with idarucizumab. Both treatments were well tolerated and no hemorrhagic or procoagulatory complications were observed. We propose that the option of dabigatran reversal needs to be considered for contemporary treatment concepts of acute ischemic stroke.
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Mutzenbach et al. (2016) studied this question.
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