Neurol. praxi. 2018;19(5):376-379 | DOI: 10.36290/neu.2018.049

The first administration of idarucizumab with subsequent intravenous thrombolysis and mechanical thrombectomy in Slovakia (a case report)

MUDr. Oto Petrík, MPH¹, MUDr. Iuliia Travkina¹, MUDr. Rastislav Bažík², MUDr. Ivan Vulev, PhD., MPH, FCIRSE², MUDr. Eva Unčovská²

¹ Neurologické oddelenie, NsP Sv. Lukáša, Galanta, Svet Zdravia, a. s., Bratislava

² CINRE – Centrum intervenčnej neurorádiológie a endovaskulárnej liečby, s. r. o., a ProCare Medissimo, Svet Zdravia, Bratislava

Intravenous thrombolysis as the basic causal therapy for acute ischaemic stroke in patients treated with novel oral anticoagulantsis contraindicated under certain circumstances. Dabigatran, as the only novel oral anticoagulant, has its specific antidote– the monoclonal antibody idarucizumab. Delivery of the antidote blocks the effect of anticoagulant therapy and allows foradministration of causal therapy for hyperacute-stage cerebral ischaemia (thrombolysis, mechanical thrombectomy). We reporta case of a 59-year-old female patient treated with dabigatran for a post-ischemic stroke state with a history of atrial fibrillationwho had a recurrence, but thrombolysis was contraindicated because of anticoagulant therapy. Following the administration ofidarucizumab, we were able to give the patient a thrombolytic drug and, given the finding of occlusion of a large cerebral artery,subsequent mechanical thrombectomy. After providing this treatment, the patient’s condition improved and she could be dischargedto home care with an NIHSS of 2b.

Keywords: idarucizumab, thrombolysis, dabigatran, stroke management

Received: June 29, 2018; Accepted: August 1, 2018; Published: October 1, 2018  Show citation