Ohya Yuichiro, Makihara Noriko, Wakisaka Kayo, Morita Takao, Ago Tetsuro, Kitazono Takanari, Takaba Hitonori
Department of Cerebrovascular Medicine, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Cerebrovascular Medicine, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan.
J Stroke Cerebrovasc Dis. 2018 Jul;27(7):e128-e131. doi: 10.1016/j.jstrokecerebrovasdis.2018.02.025. Epub 2018 Mar 16.
Whether idarucizumab, an antidote of dabigatran, can be used effectively and safely before thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) in patients with stroke undergoing treatment with dabigatran remains unknown. We herein describe a 57-year-old man who developed severe cardioembolic stroke with a National Institutes of Health Stroke Scale score of 22 in the left middle cerebral artery territory while undergoing treatment with dabigatran for nonvalvular atrial fibrillation and who was treated with rt-PA after the reversal of dabigatran with idarucizumab. The thrombolytic therapy following the use of idarucizumab significantly improved the patient's neurological symptoms without hemorrhagic complications, although acute arterial occlusion of the right lower limb was found during the clinical course.
对于正在接受达比加群治疗的中风患者，在使用重组组织型纤溶酶原激活剂（rt-PA）进行溶栓治疗之前，达比加群的解毒剂艾达赛珠单抗能否有效且安全地使用仍不清楚。我们在此描述一名57岁男性，他在接受达比加群治疗非瓣膜性心房颤动时，在左侧大脑中动脉区域发生了严重的心源性栓塞性中风，美国国立卫生研究院卒中量表评分为22分，在用艾达赛珠单抗逆转达比加群后接受了rt-PA治疗。使用艾达赛珠单抗后的溶栓治疗显著改善了患者的神经症状，且无出血并发症，尽管在临床过程中发现右下肢急性动脉闭塞。
