Recombinant Tissue-type Plasminogen Activator (rt-PA) Therapy in an Acute Stroke Patient Taking Dabigatran Etexilate: A Case Report and Literature Review

Emi Tabata; Masahiro Yasaka; Yoshiyuki Wakugawa; Yasushi Okada

doi:10.2169/internalmedicine.53.1506

CASE REPORTS

Recombinant Tissue-type Plasminogen Activator (rt-PA) Therapy in an Acute Stroke Patient Taking Dabigatran Etexilate: A Case Report and Literature Review

Emi Tabata, Masahiro Yasaka, Yoshiyuki Wakugawa, Yasushi Okada

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Keywords: recombinant tissue-type plasminogen activator (rt-PA) therapy, dabigatran, activated partial thromboplastin time (APTT)

JOURNAL OPEN ACCESS

2014 Volume 53 Issue 14 Pages 1515-1517

DOI https://doi.org/10.2169/internalmedicine.53.1506

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Abstract

Whether recombinant tissue-type plasminogen activator (rt-PA) therapy can be administered in acute stroke patients treated with dabigatran remains controversial. We administered rt-PA (0.6 mg/kg) in an acute stroke patient treated with dabigatran (110 mg bid) whose activated partial thromboplastin time (APTT) was 37.1 seconds 113 minutes after onset, 10 hours after the last dose of dabigatran. His symptoms improved from the National Institute of Health Stroke Scale score of 10 to 1 after treatment without hemorrhagic complications. The administration of rt-PA therapy is feasible in acute stroke patients on dabigatran when taking into account the APTT and time from the last dose.

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