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Updated: May 21, 2026

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

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Dabigatran: a primer for neurosurgeons.

Jennifer E Fugate¹, Alejandro A Rabinstein, Robert D McBane

¹Division of Critical Care Neurology, Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA.

World Neurosurgery

|June 23, 2012

Summary

Dabigatran offers rapid anticoagulation but poses challenges for urgent surgeries due to lack of monitoring and antidote. Managing intracranial hemorrhage in patients on dabigatran requires specific recommendations.

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Area of Science:

Pharmacology
Cardiology
Neurosurgery

Background:

Dabigatran is a novel oral anticoagulant with advantages in anticoagulation.
Its use presents unique challenges in perioperative management, particularly for urgent procedures.

Purpose of the Study:

To provide an overview of dabigatran.
To discuss implications for perioperative management of patients on dabigatran.
To offer recommendations for managing dabigatran-related intracranial hemorrhage.

Main Methods:

Literature review of English-language publications on dabigatran (Pradaxa).

Main Results:

Dabigatran provides rapid, steady anticoagulation without routine monitoring.
Lack of reliable monitoring methods complicates urgent neurosurgical procedures.
While intracranial hemorrhage risk is lower than warfarin, management is challenging due to the absence of a specific antidote.

Conclusions:

An overview of dabigatran is presented.
Implications for perioperative management are discussed.
Recommendations for managing dabigatran-associated intracranial hemorrhage are provided.