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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

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Management of acute stroke in patients taking novel oral anticoagulants

Graeme J Hankey1, Bo Norrving, Werner Hacke

  • 1School of Medicine and Pharmacology, The University of Western Australia, Perth, Western Australia, Australia.

International Journal of Stroke : Official Journal of the International Stroke Society
|June 4, 2014
PubMed

Each year, 1·0-2·0% of individuals with atrial fibrillation and 0·1-0·2% of those with venous thromboembolism who are receiving one of the novel oral anticoagulants (dabigatran, rivaroxaban, or apixaban) can be expected to experience an acute ischemic stroke. Additionally, 0·2-0·5% of individuals with atrial fibrillation who are receiving one of the novel oral anticoagulants can be expected to experience an intracranial hemorrhage. This opinion piece addresses the current literature and offers practical approaches to the management of patients receiving novel oral anticoagulants who present with an ischemic or hemorrhagic stroke. Specifically, we discuss the role of thrombolysis in anticoagulated patients with acute ischemic stroke and factors to consider concerning restarting anticoagulation after acute ischemic and hemorrhagic stroke.

Keywords:
acute strokeanticoagulantsintracerebral hemorrhagesecondary preventionthrombolytic therapy

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