Frol Senta, Pretnar Oblak Janja, Šabovič Mišo, Ntaios George, Kermer Pawel
Department of Vascular Neurology, University Medical Center Ljubljana, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Front Neurol. 2024 May 16;15:1389283. doi: 10.3389/fneur.2024.1389283. eCollection 2024.
Idarucizumab is an antibody fragment specific for the immediate reversal of dabigatran anticoagulation effects. The use of idarucizumab is approved for dabigatran-treated patients suffering from life-threatening or uncontrolled bleeding and those in need of urgent surgery or invasive procedures. Data from randomized controlled clinical trials and real-world experience provide reassuring evidence about the efficacy and safety of idarucizmab use in patients with acute stroke. In this narrative review, we summarize the available real-world evidence and discuss the relevance and importance of idarucizumab treatment in acute stroke patients in everyday clinical practice. In addition, we also discuss special issues like prothrombin complex concentrate application as an alternative to idarucizumab, its application before endovascular therapy, sensitivity of thrombi to lysis, and necessary laboratory examinations.
依达赛珠单抗是一种特异性抗体片段，用于立即逆转达比加群的抗凝作用。依达赛珠单抗已被批准用于治疗达比加群引起的危及生命或难以控制的出血患者，以及需要紧急手术或侵入性操作的患者。随机对照临床试验和真实世界经验的数据为依达赛珠单抗在急性卒中患者中的疗效和安全性提供了可靠证据。在本叙述性综述中，我们总结了现有的真实世界证据，并讨论了依达赛珠单抗治疗在日常临床实践中对急性卒中患者的相关性和重要性。此外，我们还讨论了一些特殊问题，如凝血酶原复合物浓缩物作为依达赛珠单抗替代药物的应用、其在血管内治疗前的应用、血栓对溶栓的敏感性以及必要的实验室检查。
