Thrombolysis for ischaemic stroke despite direct oral anticoagulation

Ying Xian; Duncan Wilson; David J. Seiffge; Jan C. Purrucker; Thomas R. Meinel; Teddy Y. Wu

doi:10.1136/svn-2023-002727

Stroke and Vascular Neurology ()

Thrombolysis for ischaemic stroke despite direct oral anticoagulation

Ying Xian,
Duncan Wilson,
David J. Seiffge,
Jan C. Purrucker,
Thomas R. Meinel,
Teddy Y. Wu

Affiliations

Ying Xian: The University of Texas Southwestern Medical Center, Dallas, Texas, USA
Duncan Wilson: New Zealand Brain Research Institute, Christchurch, New Zealand
David J. Seiffge: Department of Neurology and Stroke Research Center Bern, Inselspital Bern, University of Bern, Bern, Switzerland
Jan C. Purrucker: Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
Thomas R. Meinel: Department of Neurology and Stroke Research Center Bern, Inselspital Bern, University of Bern, Bern, Switzerland
Teddy Y. Wu: Department of Neurology, Christchurch Hospital, Christchurch, New Zealand

DOI: https://doi.org/10.1136/svn-2023-002727

Abstract

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Intravenous thrombolysis is not recommended in anticoagulated patients receiving direct oral anticoagulants (DOACs) and a recent intake within the last 48 hours in US and European guidelines. However, three observational studies now suggest safety of thrombolysis in patients with recent intake of DOACs, and thus support previous experimental data. In this perspective, the current evidence and practical consequences are discussed.

Published in Stroke and Vascular Neurology

ISSN: 2059-8688 (Print); 2059-8696 (Online)
Publisher: BMJ Publishing Group
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry: Neurology. Diseases of the nervous system
Website: https://svn.bmj.com

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