Pásztor Máté, Bereczki Dániel, Szakács Zoltán, May Zsolt
Magyar Honvédség Egészségügyi Központ, Neurológiai Osztály, Budapest.
Ideggyogy Sz. 2017 Jul 30;70(7-8):284-288. doi: 10.18071/isz.70.0284.
Introduction - Expanding indications have resulted in an increasing number of patients taking novel oral anticoagulants, posing a major treatment dilemma in acute ischemic stroke. Case presentation - We present a successful intravenous thrombolysis in a dabigatran-treated patient with acute ischemic stroke after the administration of idarucizumab. Discussion - According to current guidelines, systemic thrombolysis is contraindicated under treatment with novel oral anticoagulants (taken within 48 hours). In this scenario, idarucizumab offers a solution by reversing the anticoagulant effect of dabigatran. Conclusion - Although there have only been case reports published so far, the dabigatran-antidote idarucizumab seems to give new therapeutic opportunities in the treatment of acute ischemic stroke.
引言——适应证的不断扩大导致服用新型口服抗凝药的患者数量增加，这给急性缺血性卒中带来了重大治疗难题。病例报告——我们报告了1例在给予达比加群治疗的患者中，在使用依达赛珠单抗后成功进行静脉溶栓的病例。讨论——根据当前指南，在新型口服抗凝药治疗期间（48小时内服用）全身溶栓是禁忌的。在这种情况下，依达赛珠单抗通过逆转达比加群的抗凝作用提供了一种解决方案。结论——尽管目前仅有病例报告发表，但达比加群解毒剂依达赛珠单抗似乎为急性缺血性卒中的治疗带来了新的治疗机会。
