title: Use of rivaroxaban in patients with stroke.
abstract: Rivaroxaban, an inhibitor of Factor Xa, is a direct oral anti-coagulant that has been found to be non-inferior to warfarin in preventing cerebral ischemia in patients with non-valvular atrial fibrillation and in the subgroup of patients with a history of the previous stroke or transient ischemic attack. Vascular neurologists in daily clinical practice may encounter patients taking rivaroxaban or patients who may benefit from its use. In this paper, we review the current clinical indications, contraindications, and clinical management guidelines for rivaroxaban while providing a special focus on neurological aspects and expert opinions on rivaroxaban therapy management in various situations that a neurologist may encounter when treating patients with an ischemic stroke (including those requiring intravenous or intra-arterial reperfusion therapy) and patients with an intracerebral hemorrhage. Since data from clinical trials and real-life data are missing in some clinical situations, strong recommendations are not always available. Nevertheless, practical guidelines should be adopted to maximize benefits from this oral anti-coagulant.
authors.affiliation: Unità di Trattamento Neurovascolare, University La Sapienza Rome, Viale del Policlinico 155, 00161, Rome, Italy. danilo.toni@uniroma1.it.
authors.forename: Danilo
authors.initials: D
authors.lastname: Toni
authors.affiliation: Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Carolei
authors.affiliation: Stroke Unit, Perugia, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Caso
authors.affiliation: U.O. Neurologia e Stroke Unit, PO "G. Jazzolino", Vibo Valentia, VV, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Consoli
authors.affiliation: S.C. Neurologia, Ente Ospedaliero Ospedali Galliera Genova, Genoa, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Del Sette
authors.affiliation: Department of NEUROFARBA, Neuroscience SectionUniversity of Florence, Florence, Italy.|Institute of Neuroscience, Italian National Research Council, Florence, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Inzitari
authors.affiliation: SC Neurologia e Stroke UnitAzienda Ospedaliera G. Brotzu, Cagliari, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Melis
authors.affiliation: Dipartimento di Neurologia d'Urgenza, IRCCS Fondazione Istituto Neurologico Nazionale C. Mondino, Pavia, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Micieli
authors.affiliation: Clinica Neurologica, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Leandro
authors.initials: L
authors.lastname: Provinciali
authors.affiliation: UO Neurologia, USL Umbria 1, Sedi di Città di Castello e Branca, Trento, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Ricci
authors.affiliation: Fondazione IRCCS Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Santalucia
authors.affiliation: Italian Stroke Organisation, Florence, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Toso
mesh_terms: D065427:Factor Xa Inhibitors / Q000627:therapeutic use*; D006801:Humans; D000069552:Rivaroxaban / Q000627:therapeutic use*; D020521:Stroke / Q000188:drug therapy*
chemical_list: D065427:Factor Xa Inhibitors; D000069552:Rivaroxaban
keywords: Anti-coagulants; Atrial fibrillation; Intracerebral hemorrhage; Ischemic stroke; Rivaroxaban