title: Safe intravenous thrombolysis in acute stroke despite treatment with rivaroxaban.
abstract: Data regarding intravenous thrombolysis in stroke patients receiving new oral anticoagulant drugs (nOAC) is sparse. In the near future, however, an increasing number of patients with atrial fibrillation will suffer recurrent stroke despite treatment with nOAC. This will cause a significant therapeutic dilemma as thrombolysis is contraindicated under such circumstances. We describe an 81-year-old patient presenting with acute ischemic stroke who was successfully treated with intravenous thrombolysis despite ongoing treatment with rivaroxaban. Our case report indicates that thrombolysis under nOAC may be safe under certain conditions and emphasizes the importance of establishing and performing specific anticoagulation tests for nOAC.
authors.affiliation: Department of Neurology, University Medical Center Freiburg, Breisacher Straße 64, 79106 Freiburg, Germany. Electronic address: katharina.bornkamm@uniklinik-freiburg.de.
authors.forename: Katharina
authors.initials: K
authors.lastname: Bornkamm
authors.affiliation: Department of Neurology, University Medical Center Freiburg, Breisacher Straße 64, 79106 Freiburg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Harloff
mesh_terms: D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000150:complications; D001777:Blood Coagulation / Q000187:drug effects; D065427:Factor Xa Inhibitors / Q000008:administration & dosage; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D000069552:Rivaroxaban / Q000008:administration & dosage*; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D005343:Fibrinolytic Agents; D000069552:Rivaroxaban
keywords: Anticoagulation; Ischemic stroke; Rivaroxaban; Thrombolysis