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Dabigatran etexilate: management in acute ischemic stroke.
Abstract A 54-year-old man treated with dabigatran experienced new onset of a stroke with a score of 9 on the National Institutes of Health Stroke Scale. Administration of recombinant tissue plasminogen activator (rtPA) was not recommended because of the dabigatran therapy. Angiography showed occlusion of the left middle cerebral artery by an embolic thrombus. Suction thrombectomy achieved flow through the inferior division of the artery. Computed tomography of the head showed possible intracranial hemorrhage, and dabigatran reversal was attempted with prothrombin complex concentrate and recombinant factor VIIa. C...
Source: American Journal of Critical Care - March 1, 2013 Category: Nursing Authors: Javedani PP, Horowitz BZ, Clark WM, Lutsep HL Tags: Am J Crit Care Source Type: research

Reversing the effects of the new anti-clotting drugs
The oral anticoagulant warfarin (Coumadin) became available for prescription in 1954. This anti-clotting drug commanded national attention when President Dwight Eisenhower received the drug as part of his treatment following a heart attack. No other oral anticoagulant was successfully developed and marketed in the United States until 2010. Warfarin is a dangerous drug. Along with insulin, it is responsible for the most emergency hospitalizations due to adverse drug reactions. Whereas insulin causes low blood sugar, warfarin is notorious for the complication of major bleeding. Warfarin is plagued by hundreds of drug-drug an...
Source: New Harvard Health Information - December 9, 2015 Category: Consumer Health News Authors: Samuel Z. Goldhaber, MD Tags: Drugs and Supplements Health Heart Health Hypertension and Stroke anti-clotting coumadin deep-vein-thrombosis DVT Source Type: news

Early introduction of direct oral anticoagulants in cardioembolic stroke patients with non-valvular atrial fibrillation
AbstractDirect oral anticoagulants (DOACs) are superior to warfarin in reduction of the intracranial bleeding risk. The aim of the present study was to assess whether early DOAC introduction (1 –3 days after onset) in stroke patients with non-valvular atrial fibrillation (nVAF) may be safe and effective, compared with DOAC introduction after 4–7 days. We conducted a prospective analysis based on data collected from 147 consecutive nVAF patients who started DOAC within 7 days after stro ke onset. In all patients, we performed pre-DOAC CT scan 24–36 h after onset and follow-up CT scan at 7 days after DOAC introduction...
Source: Journal of Thrombosis and Thrombolysis - September 3, 2016 Category: Hematology Source Type: research

A Case of Ischemic Stroke With Congenital Protein C Deficiency and Carotid Web Successfully Treated by Anticoagulant and Carotid Stenting
Conclusion: To our knowledge, this is the first report in which an immediate thrombus formation on the carotid web was observed in a patient with congenital protein C deficiency. In a case of acute ischemic stroke with carotid web, especially when congenital coagulopathy such as protein C deficiency is suspected, careful follow-up with ultrasound imaging should be performed.
Source: Frontiers in Neurology - February 17, 2020 Category: Neurology Source Type: research

Organizational changes aiming to reduce iv tPA door‐to‐needle time
ConclusionsStreamlining of iv tPA logistics can reduce median DNT to <30 min in a general local hospital. Moving treatment start from the ER to the CT laboratory contributed to reduce DNT. Our organizational model was resistant to influence on DNT by patient age, gender, stroke severity, and time to hospital arrival. The incidence of SICH remained low.
Source: Acta Neurologica Scandinavica - November 23, 2013 Category: Neurology Authors: E. T. Thortveit, M. G. Bøe, U. Ljøstad, Å. Mygland, A. Tveiten Tags: Original Article Source Type: research

Efficacy and Safety of Direct Oral Factor Xa Inhibitors in 795 Morbidly Obese Patients
Conclusions: Our study is the largest study examining morbidly obese patients on DOACS and provides further evidence of comparable efficacy and safety of the direct oral anti-Xa inhibitors, compared to warfarin, in morbidly obese patients with AF and VTE.DisclosuresKushnir: Janssen: Research Funding. Billett: Bayer: Consultancy; Janssen: Research Funding.
Source: Blood - November 21, 2018 Category: Hematology Authors: Kushnir, M., Choi, Y., Eisenberg, R., Rao, D., Tolu, S., Gao, J., Mowrey, W., Billett, H. H. Tags: 332. Antithrombotic Therapy: Management of Challenging Patients and Scenarios Source Type: research

Direct Oral Anticoagulation versus Warfarin in Left Ventricular Thrombus: Pooled Analysis of Randomized Controlled Trials
In conclusion, pooled analysis of RCT data favors DOAC over VKA in patients with LV thrombus both in terms of efficacy and safety. This article is protected by copyright. All rights reserved.PMID:37139934 | DOI:10.1002/jcph.2267
Source: The Journal of Clinical Pharmacology - May 4, 2023 Category: Drugs & Pharmacology Authors: Anders Olof Sahl én Haowen Jiang Yee How Lau Lucky Cuenza F Aaysha Cader Mohammed Al-Omary Purich Surunchupakorn Ka Hei Ho Jonathan Sung Derek Lee Satoshi Honda Ack Tan Wei Chieh Jonathan Yap Source Type: research

The Case Files: Unusual Headache
By Al-Hashimi, Siddhartha DO; Leavens, John MD A 23-year-old woman with a history of migraine headaches presented to the emergency department for a different-than-usual headache. She had a six-day history of intermittent headaches. The onset was at rest, and there was no history of trauma.   The headache was located behind her left eye, and it radiated into the posterior portion of her head. She characterized it as being 8/10 in intensity. Bright lights were reported as an exacerbating factor. The headache was associated with nausea and multiple episodes of emesis. She had 10 episodes of vomiting the evening prior to arri...
Source: The Case Files - June 5, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: research

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