Prehospital idarucizumab prior to intravenous thrombolysis in a mobile stroke unit

International Journal of Stroke : Official Journal of the International Stroke Society
Henry ZhaoS Davis

Abstract

Administration of intravenous idarucizumab to reverse dabigatran anticoagulation prior to thrombolysis for patients with acute ischemic stroke has been previously described, but not in the prehospital setting. The speed and predictability of idarucizumab reversal is well suited to prehospital treatment in a mobile stroke unit and allows patients with recent dabigatran intake to access reperfusion therapy. To describe feasibility of prehospital idarucizumab administration prior to thrombolysis on the Melbourne mobile stroke unit. The Melbourne mobile stroke unit is a specialized stroke ambulance servicing central metropolitan Melbourne, Australia and provides prehospital assessment, scanning and treatment with an integrated CT scanner and multidisciplinary stroke team. All cases were identified through the mobile stroke unit treatment registry since launch in November 2017. Of a total of n = 20 thrombolysis cases in the first 4 months of operation, three patients (15%) received intravenous idarucizumab 5 g for dabigatran reversal prior to thrombolysis. Mean time between idarucizumab administration and thrombolysis was approximately 10 minutes. Two of the three patients were shown to have large vessel occlusion on CTA in the mobi...Continue Reading

References

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Citations

Feb 23, 2020·Stroke; a Journal of Cerebral Circulation·Henry ZhaoStephen M Davis
Jan 27, 2019·Current Atherosclerosis Reports·D A CadilhacJ Kim
Oct 12, 2019·Nature Reviews. Disease Primers·Bruce C V CampbellGeoffrey A Donnan
Mar 27, 2020·Stroke; a Journal of Cerebral Circulation·James BeharryTeddy Y Wu
Jun 17, 2020·International Journal of Stroke : Official Journal of the International Stroke Society·Joosup KimDominique A Cadilhac
Jun 21, 2020·Lancet Neurology·Klaus FassbenderJames C Grotta
May 27, 2021·Journal of Neurology, Neurosurgery, and Psychiatry·Klaus FassbenderJames Grotta

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