title: Good outcome after intravenous thrombolysis for acute stroke in a patient under treatment with dabigatran.
abstract: The novel oral anticoagulants (NOACs) are indicated for stroke and systemic embolism prophylaxis in patients with nonvalvular atrial fibrillation (AF). Very few cases of intravenous recombinant tissue plasminogen activator (IV rt-PA) in patients under treatment with NOACs have been described. The decision to thrombolyze patients under NOACs is complex and requires a balance between the benefits of treatment and the risk of symptomatic hemorrhagic complications.We describe an unusual case of treatment IV rt-PA for acute ischemic stroke in a patient receiving dabigatran for AF. The decision to treat the patient with IV rt-PA was based on the combination of normal coagulation times with the long time elapsed after the last dose of dabigatran, when the drug effect was predictably residual.
authors.affiliation: Department of Internal Medicine, Unidade Local de Saúde do Litoral Alentejano (ULSLA).
authors.forename: Cátia
authors.initials: C
authors.lastname: Diogo
authors.affiliation: Department of Internal Medicine, Unidade Local de Saúde do Litoral Alentejano (ULSLA).
authors.forename: Josiana
authors.initials: J
authors.lastname: Duarte
authors.affiliation: Department of Internal Medicine, Unidade Local de Saúde do Litoral Alentejano (ULSLA).
authors.forename: Sofia
authors.initials: S
authors.lastname: Sobral
authors.affiliation: Department of Internal Medicine, Unidade Local de Saúde do Litoral Alentejano (ULSLA); National Institute of Medical Emergency (INEM).
authors.forename: Paula
authors.initials: P
authors.lastname: Pestana
authors.affiliation: National Institute of Medical Emergency (INEM); Department of Neurology, Centro Hospitalar do Algarve (CHA). Electronic address: nzwalo@gmail.com.
authors.forename: Hipólito
authors.initials: H
authors.lastname: Nzwalo
authors.affiliation: Department of Internal Medicine, Unidade Local de Saúde do Litoral Alentejano (ULSLA); National Institute of Medical Emergency (INEM).
authors.forename: Henrique
authors.initials: H
authors.lastname: Rita
authors.affiliation: Department of Internal Medicine, Unidade Local de Saúde do Litoral Alentejano (ULSLA).
authors.forename: José
authors.initials: J
authors.lastname: Sousa E Costa
mesh_terms: D000991:Antithrombins / Q000009:adverse effects* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy*; D001562:Benzimidazoles / Q000009:adverse effects* / Q000627:therapeutic use; D000069604:Dabigatran; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D015091:beta-Alanine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000991:Antithrombins; D001562:Benzimidazoles; D005343:Fibrinolytic Agents; D015091:beta-Alanine; D010959:Tissue Plasminogen Activator; D000069604:Dabigatran