Ritzenthaler T, Derex L, Davenas C, Bnouhanna W, Farghali A, Mechtouff L, Cho T-H, Nighoghossian N
Service d'urgences neuro-vasculaires, hôpital neurologique Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 59677 Bron cedex, France; CREATIS, université de Lyon, CNRS UMR 5220, Inserm U1044, INSA-Lyon, université Lyon 1, hospices civils de Lyon, 69500 Villeurbanne cedex, France.
Service d'urgences neuro-vasculaires, hôpital neurologique Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 59677 Bron cedex, France.
Rev Neurol (Paris). 2015 Sep;171(8-9):613-5. doi: 10.1016/j.neurol.2015.02.012. Epub 2015 Apr 7.
The introduction of direct oral anticoagulants (DOA) in the early stage of cerebral infarction after thrombolysis may reduce the recurrence rate but raises safety concern. We sought to study the feasibility and safety of the introduction of rivaroxaban or dabigatran in this context. Thirty-four consecutive patients admitted for ischemic stroke related to non-valvular atrial fibrillation in whom DOA were given within the first two weeks following intravenous rt-PA were studied. A clinical and radiological monitoring protocol was established to ensure the safety of the prescription. None of the patients experienced symptomatic hemorrhagic transformation or a symptomatic recurrent ischemic event after early rivaroxaban or dabigatran introduction.
在溶栓后早期脑梗死阶段引入直接口服抗凝剂（DOA）可能会降低复发率，但引发了安全性担忧。我们试图研究在此背景下引入利伐沙班或达比加群的可行性和安全性。对34例因非瓣膜性心房颤动相关缺血性卒中入院且在静脉注射rt-PA后的头两周内接受DOA治疗的连续患者进行了研究。建立了临床和影像学监测方案以确保用药安全。在早期引入利伐沙班或达比加群后，没有患者发生症状性出血转化或症状性复发性缺血事件。
