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Proposed Approach to Thrombolysis in Dabigatran-Treated Patients Presenting with Ischemic Stroke
Background: Acute ischemic stroke thrombolysis in patients taking dabigatran is controversial because of a presumed increased risk of symptomatic hemorrhagic transformation. Using data from our local hematopathology laboratory, we developed a thrombolysis protocol for acute ischemic stroke patients taking dabigatran.Methods: A local thrombin time (TT)–dabigatran concentration relationship was calculated using dabigatran calibrators. The effect of dabigatran on activated partial thromboplastin time (aPTT) and prothrombin time (PT) (international normalized ratio [INR]) was also measured. A protocol was developed, in which...
Source: Journal of Stroke and Cerebrovascular Diseases - January 9, 2014 Category: Neurology Authors: Mahesh Kate, Artur Szkotak, Adam Witt, Ashfaq Shuaib, Kenneth Butcher Tags: Original Articles Source Type: research

Acute Stroke Despite Dabigatran Anticoagulation Treated with Idarucizumab and Intravenous Tissue Plasminogen Activator
Dabigatran is a direct thrombin inhibitor used to reduce the risk of stroke in patients with nonvalvular atrial fibrillation. For patients who present with an acute stroke despite dabigatran therapy, clinical data on the use of intravenous tissue plasminogen activator (IV-tPA) is limited. There is an anticipated increased risk of symptomatic intracranial hemorrhage (sICH) when using IV-tPA in patients on dabigatran therapy. In 2015, the humanized monoclonal antibody fragment idarucizumab was approved for rapid (minutes) reversal of anticoagulant effects of dabigatran.
Source: Journal of Stroke and Cerebrovascular Diseases - April 14, 2017 Category: Neurology Authors: David Bissig, Rashmi Manjunath, Brittany R. Traylor, David P. Richman, Kwan L. Ng Tags: Case Studies Source Type: research

Pharmacological Difference Between Platelet Aggregations in Cardioembolic Stroke Patients with Direct Oral Anticoagulants: A Pilot Study
Major hemorrhagic complication incidence in patients with arterial fibrillation (AF), and treated with direct oral anticoagulants (DOACs), is lower than in vitamin K antagonist-treated patients.1 –5 Additionally, among DOACs, the direct oral thrombin inhibitor (dabigatran) and direct oral factor Xa (FXa) inhibitors (apixaban and rivaroxaban) seem to affect the coagulation system differently, which could provide distinct clinical outcomes.6,7 The results from the US6 and Denmark8 cohort stu dies suggest there is a minute, but notable difference in major bleeding complication incidence between dabigatran and FXa inhibitors.
Source: Journal of Stroke and Cerebrovascular Diseases - May 3, 2022 Category: Neurology Authors: Masahito Nakazaki, Shinichi Oka, Hirotoshi Magota, Ryo Kiyose, Rie Onodera, Ryo Ukai, Yuko Kataoka-Sasaki, Masanori Sasaki, Osamu Honmou Source Type: research

Dabigatran-related Intracerebral Hemorrhage Resulting in Hematoma Expansion
We present a case that suggests that hematoma expansion may occur after NOAC-related ICH.
Source: Journal of Stroke and Cerebrovascular Diseases - October 7, 2013 Category: Neurology Authors: Claus Z. Simonsen, Thorsten Steiner, Anna Tietze, Dorte Damgaard Tags: Case Reports Source Type: research

Do the Antithrombotic Therapy at the Time of Intracerebral Hemorrhage Influence Clinical Outcome? Analysis between the Difference of Antiplatelet and Anticoagulant Agents and Clinical Course
Background: It is controversial whether taking antiplatelet agents (APs) or anticoagulant agents (ACs) could influence clinical outcome after intracerebral hemorrhage (ICH).Methods: We retrospectively investigated 557 ICH patients between September 2008 and August 2013. We reviewed patients' characteristics, hematoma volume, deterioration (hematoma expansion, surgical hematoma evacuation, or death), and clinical outcome in modified Rankin Scale.Results: A total of 397 were classified as neither AP nor AC (“Nothing”), 81 as single AP (44 as aspirin [ASA], 22 as clopidogrel or ticlopidine [CLP/TIC], 7 as cilostazol, 8 as...
Source: Journal of Stroke and Cerebrovascular Diseases - June 23, 2014 Category: Neurology Authors: Takeshi Okada, Taizen Nakase, Masahiro Sasaki, Tatsuya Ishikawa Tags: Original Articles Source Type: research

Does Dabigatran Increase the Risk of Delayed Hematoma Expansion in a Rat Model of Collagenase-Induced Intracerebral Hemorrhage?
This study aims to clarify whether dabigatran increases the risk of delayed hematoma expansion in a rat ICH model.
Source: Journal of Stroke and Cerebrovascular Diseases - November 25, 2014 Category: Neurology Authors: Shunsuke Tanoue, Joji Inamasu, Masayuki Yamada, Hiroshi Toyama, Yuichi Hirose Source Type: research