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Source: Journal of Stroke and Cerebrovascular Diseases
Drug: Pradaxa
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Total 29 results found since Jan 2013.
Treatment of Acute Stroke in Patients on Dabigatran: A Survey of US Stroke Specialists
Conclusions: There is a remarkable lack of consensus among vascular neurologists regarding the assessment and treatment of acute stroke patients on dabigatran.
Source: Journal of Stroke and Cerebrovascular Diseases - January 14, 2013 Category: Neurology Authors: Igor Rybinnik, Michael T. Mullen, Steven Messe, Scott E. Kasner, Brett Cucchiara Tags: Original Articles Source Type: research
Dilemma of Indication for Thrombolysis in a Patient with Acute Ischemic Stroke Treated with a Novel Oral Anticoagulant
We report the case of a patient treated with dabigatran who developed acute ischemic stroke and was considered for thrombolysis. Because of the prolonged thrombin time (TT), thrombolysis was not performed. Repeated coagulation tests 5 days after stroke, with unchanged anticoagulant (dabigatran) treatment, found 2-fold higher TT and activated partial thromboplastin time (APTT) compared with the values found in the acute stage. Routine coagulation tests (TT and APTT) do not reliably reflect the coagulation features of a patient; therefore, there is an urgent need to develop reliable biomarkers and an adequate guideline to ...
Source: Journal of Stroke and Cerebrovascular Diseases - May 30, 2013 Category: Neurology Authors: András Folyovich, Viktória Varga, Katalin A. Béres-Molnár, Károly Vadasdi, Dániel Bereczki Tags: Case Reports Source Type: research
Thrombolytic Therapy in Severe Cardioembolic Stroke After Reversal of Dabigatran with Idarucizumab: Case Report and Literature Review
Whether idarucizumab, an antidote of dabigatran, can be used effectively and safely before thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) in patients with stroke undergoing treatment with dabigatran remains unknown. We herein describe a 57-year-old man who developed severe cardioembolic stroke with a National Institutes of Health Stroke Scale score of 22 in the left middle cerebral artery territory while undergoing treatment with dabigatran for nonvalvular atrial fibrillation and who was treated with rt-PA after the reversal of dabigatran with idarucizumab.
Source: Journal of Stroke and Cerebrovascular Diseases - March 16, 2018 Category: Neurology Authors: Yuichiro Ohya, Noriko Makihara, Kayo Wakisaka, Takao Morita, Tetsuro Ago, Takanari Kitazono, Hitonori Takaba Tags: Case Studies Source Type: research
Intravenous Thrombolysis in Acute Ischemic Stroke After Idarucizumab Reversal of Dabigatran Effect: Analysis of the Cases From Taiwan
Background: Asians with atrial fibrillation carry a higher risk of ischemic stroke than non-Asians even under treatment of nonvitamin K antagonist oral anticoagulants. The purpose of the study was to observe the feasibility of intravenous thrombolytic therapy after administering a reversal agent, idarucizumab, in dabigatran-treated patients with acute ischemic stroke in Taiwan. Methods: Dabigatran-treated patients with acute ischemic stroke who received intravenous recombinant tissue plasminogen activator (rt-PA) after idarucizumab reversal were enrolled in the retrospective nationwide study.
Source: Journal of Stroke and Cerebrovascular Diseases - December 17, 2018 Category: Neurology Authors: Chen-Wen Fang, Yi-Te Tsai, Ping-Chen Chou, Hsi-Ming Chen, Chien-Ming Lu, Chen-Rong Tsao, Chih-Lin Chen, Mu-Chien Sun, Yu-Song Shih, Cheng-Yang Hsieh, Lu-An Chen, Po-Lin Chen, Jung-Tze Yeh, Yi-Heng Li Source Type: research
Dabigatran for Japanese Patients with Atrial Fibrillation and Prior Stroke: A Subgroup Analysis of the J-Dabigatran Surveillance Program
Background: The study objective was to evaluate long-term safety and effectiveness of dabigatran 110 mg and 150 mg twice daily (bid) in patients with nonvalvular atrial fibrillation (NVAF) with a focus on secondary stroke prevention. Methods: In J-Dabigatran Surveillance, 6772 patients newly initiated on dabigatran to prevent ischemic stroke and systemic embolism were enrolled in Japan (1042 sites, December 2011 to November 2013). This subgroup analysis included patients with (1302) and without (5071) previous stroke/transient ischemic attack (TIA).
Source: Journal of Stroke and Cerebrovascular Diseases - February 25, 2020 Category: Neurology Authors: Masahiro Yasaka, Shinichiro Uchiyama, Hirotsugu Atarashi, Ken Okumura, Yukihiro Koretsune, Takeshi Yamashita, Atsushi Taniguchi, Taku Fukaya, Hiroshi Inoue, for the J-Dabigatran Surveillance Investigators Tags: Original article Source Type: research
Insights Into Direct Oral Anticoagulant Therapy Implementation of Stroke Survivors with Atrial Fibrillation in an Ambulatory Setting
Atrial fibrillation (AF) is the most common cardiac arrhythmia and increases the risk of ischemic stroke by about five times.1 Oral anticoagulation (OAC) with direct oral anticoagulants (DOAC) or vitamin K antagonists (VKA) reduces ischemic stroke risk in AF patients. Currently, DOAC (apixaban, dabigatran, edoxaban and rivaroxaban) are recommended as first-line treatment for stroke prevention in AF patients.2 Despite several advantages compared to VKA, DOAC have a short half-life of about 12 h. Missing more than 5% of intakes is associated with a higher occurrence of thromboembolic events in OAC-treated AF patients.
Source: Journal of Stroke and Cerebrovascular Diseases - December 14, 2020 Category: Neurology Authors: Valerie Albert, Alexandros A. Polymeris, Fine Dietrich, Stefan T. Engelter, Kurt E. Hersberger, Sabine Schaedelin, Philippe A. Lyrer, Isabelle Arnet Source Type: research
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
Intravenous Fibrinolysis in Ischemic Stroke of Large Vessel after Reversing Effect of Dabigatran with Idarucizumab
We present our experience regarding the use of intravenous tissue plasminogen activator in a patient with ischemic stroke due to complete occlusion of the left middle cerebral artery after blocking the effect of dabigatran with idarucizumab and whose result was an almost total improvement of the neurologic deficit.
Source: Journal of Stroke and Cerebrovascular Diseases - June 26, 2017 Category: Neurology Authors: Gary Alvarez Bravo, Emilio Orts Castro, Guilherme Carvalho Monteiro, Ignacio L ópez Zuazo Tags: Case Studies Source Type: research
Intravenous Thrombolysis After Idarucizumab Application in Acute Stroke Patients —A Potentially Increased Sensitivity of Thrombi to Lysis?
Background: Rapid inactivation of dabigatran by its specific inhibitor idarucizamab allows intravenous thrombolysis (IVT) in patients suffering ischemic stroke while being treated with dabigatran. Only limited data of this approach is available and numerous questions regarding efficacy/safety remain to be answered. Herein, we present the findings from the Slovenian national cohort study. Methods: Retrospective analysis of all stroke patients treated with idarucizumab and IVT (n = 11) in the period from July 2016 to February 2018 from Slovenian region were analyzed.
Source: Journal of Stroke and Cerebrovascular Diseases - December 6, 2018 Category: Neurology Authors: Janja Pretnar Oblak, Miso Sabovic, Senta Frol Source Type: research
Recurrent Ischemic Stroke in a Patient with the Trousseau Syndrome Treated with Dabigatran
A 70-year-old man with multiple ischemic strokes was diagnosed with cardiac embolism and treated with dabigatran. Three months later, he suddenly developed vertigo and vomiting. Magnetic resonance imaging, showed recurrent lesions and blood tests revealed hypercoagulability, hypoproteinemia, and elevated cytokeratin 19 fragments that serve as a tumor marker of lung cancer. Chest computed tomography showed there were small nodules in bilateral lungs and swollen mediastinal lymph nodes. A conclusive diagnosis was impossible because the patient declined invasive procedures. We suspected primary lung cancer and diagnosed conco...
Source: Journal of Stroke and Cerebrovascular Diseases - February 21, 2014 Category: Neurology Authors: Kosuke Yoshida, Takashi Kimura, Yoko Aburakawa, Yasuhiro Suzuki, Kenji Kuroda, Osamu Yahara Tags: Case Reports Source Type: research
Systemic Thrombolysis for Ischemic Stroke after Antagonizing Dabigatran with Idarucizumab—A Case Report
We here describe our experience of systemic thrombolysis therapy for severe ischemic stroke in a patient taking dabigatran for atrial fibrillation. After administration of the monoclonal antibody fragment idarucizumab, the anticoagulative effects of dabigatran were efficiently antagonized and application of alteplase was safe and feasible in our patient. This case report may illustrate a novel treatment option in the neurological emergency setting.
Source: Journal of Stroke and Cerebrovascular Diseases - May 24, 2016 Category: Neurology Authors: Niklas Schäfer, Andreas Müller, Ullrich Wüllner Tags: Case Studies Source Type: research
Systemic Thrombolysis for Ischemic Stroke after Antagonizing Dabigatran with Idarucizumab —A Case Report
We here describe our experience of systemic thrombolysis therapy for severe ischemic stroke in a patient taking dabigatran for atrial fibrillation. After administration of the monoclonal antibody fragment idarucizumab, the anticoagulative effects of dabigatran were efficiently antagonized and application of alteplase was safe and feasible in our patient. This case report may illustrate a novel treatment option in the neurological emergency setting.
Source: Journal of Stroke and Cerebrovascular Diseases - May 24, 2016 Category: Neurology Authors: Niklas Sch äfer, Andreas Müller, Ullrich Wüllner Tags: Case Studies Source Type: research
