Baule Antonio, Cabigiosu Federico, Zanda Bastianina, Sanna Alessandra, Mongili Claudia, Manca Antonio
Stroke Unit, Department of Neuroscience, AOU Sassari, Italy.
Clinica Medica, Department of Medicine, AOU Sassari, Italy.
J Vasc Interv Neurol. 2018 Nov;10(2):15-17.
Dabigatran is one of the nonvitamin K antagonist oral anticoagulants. Thrombolytic treatment with intravenous recombinant tissue plasminogen activator is contraindicated in patients taking a DOAC. Idarucizumab was recently approved for dabigatran-activity reversing in severe bleeding, emergency surgery, or urgent procedures, but many attempts have been made to use idarucizumab in patients presenting with acute ischemic stroke in order to be eligible for thrombolysis.
Our patient was an 89-year-old woman with severe aphasia who was treated with dabigatran for nonvalvular atrial fibrillation. She received an infusion of idarucizumab followed by thrombolytic therapy, with complete remission of symptoms after 24 hours.
Idarucizumab is a safe option for patients with acute ischemic stroke treated with dabigatran; otherwise eligibles for thrombolysis, even in very old people like our patient.
达比加群是一种非维生素K拮抗剂口服抗凝药。正在服用直接口服抗凝剂（DOAC）的患者禁忌使用静脉注射重组组织型纤溶酶原激活剂进行溶栓治疗。艾达西珠单抗最近被批准用于在严重出血、急诊手术或紧急操作中逆转达比加群的活性，但人们已多次尝试在急性缺血性卒中患者中使用艾达西珠单抗，以便能够进行溶栓治疗。
我们的患者是一名89岁的严重失语女性，因非瓣膜性心房颤动接受达比加群治疗。她接受了艾达西珠单抗输注，随后进行了溶栓治疗，24小时后症状完全缓解。
对于接受达比加群治疗的急性缺血性卒中患者，艾达西珠单抗是一种安全的选择；对于其他符合溶栓条件的患者也是如此，即使是像我们的患者这样的高龄患者。
