Successful intravenous thrombolysis in a patient with ischemic stroke, after reversal of Dabigatran with Idarucizumab – A case report

There remains a risk of ischemic strokes in patients of atrial fibrillation receiving oral anticoagulants. Systemic thrombolysis in such cases poses a challenge, but may be possible after reversal of anticoagulant effect. We report a case of 61-year old male patient with non-valvular atrial fibrillation who was taking dabigatran. The patient developed ischemic stroke few hours after taking the last dose of the anticoagulant. Reversal of dabigatran was achieved using idarucizumab, and the patient was successfully thrombolysed. This case-report adds to the growing evidence that such a strategy is now possible with the advent of reversal agents against non-vitamin K antagonist oral anticoagulants.

Keywords: Stroke, Dabigatran, Idarucizumab, Reversal.