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Updated: Jul 4, 2025

Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Thrombolysis for ischaemic stroke despite direct oral anticoagulation
Jan C Purrucker1, Thomas R Meinel2, Duncan Wilson3
1Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany jan.purrucker@med.uni-heidelberg.de.
None:
Intravenous thrombolysis is not recommended in anticoagulated patients receiving direct oral anticoagulants (DOACs) and a recent intake within the last 48 hours in US and European guidelines. However, three observational studies now suggest safety of thrombolysis in patients with recent intake of DOACs, and thus support previous experimental data. In this perspective, the current evidence and practical consequences are discussed.
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