Key result
Reversal of dabigatran with idarucizumab followed by systemic thrombolysis with alteplase was successfully performed in a patient with acute ischaemic stroke, resulting in no haemorrhagic complications.
Case Report (n=1)
No
Idarucizumab can safely reverse dabigatran to facilitate systemic thrombolysis in patients with acute ischaemic stroke.
Supports feasibility of idarucizumab reversal before thrombolysis in dabigatran-treated stroke; leaves open need for prospective safety confirmation.
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.
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Loh et al. (2019) conducted a case report in Acute ischaemic stroke (n=1). Idarucizumab followed by alteplase was evaluated on Haemorrhagic transformation post-thrombolysis. Reversal of dabigatran with idarucizumab followed by systemic thrombolysis with alteplase was successfully performed in a patient with acute ischaemic stroke, resulting in no haemorrhagic complications.
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