Acute ischemic stroke treated with intravenous tissue plasminogen activator in a patient taking dabigatran with radiographic evidence of recanalization

Navdeep Sangha, Ramy El Khoury, Vivek Misra, George Lopez

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Dabigatran etexelate is a new oral direct thrombin inhibitor that has been approved by the US Food and Drug Administration to prevent stroke in patients with nonvalvular atrial fibrillation. A 51-year-old man with a history of atrial fibrillation who was taking dabigatran presented with an acute ischemic stroke. The patient had a normal international normalized ratio, activated partial thromboplastin time, and an elevated thrombin time of 26.4 seconds. Recanalization of the middle cerebral artery with intravenous tissue plasminogen activator was apparent on digital subtraction angiography, and there was no evidence of intracerebral hemorrhage on the repeat computed tomographic scan. This is the first report of a patient who was taking dabigatran etexilate and who had an ischemic stroke caused by a middle cerebral artery occlusion, with an elevated thrombin time and radiographic recanalization with intravenous tissue plasminogen activator without evidence of hemorrhagic transformation.

Original languageEnglish (US)
Pages (from-to)917.e5-917.e8
JournalJournal of Stroke and Cerebrovascular Diseases
Volume21
Issue number8
DOIs
StatePublished - Nov 2012

Keywords

  • Acute ischemic stroke
  • anticoagulant
  • anticoagulation
  • dabigatran
  • intravenous recombinant tissue plasminogen activator
  • thrombolysis

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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