Hemorrhagic complications after stroke treatment with intravenous thrombolysis despite use of direct oral anticoagulants: an observational study
Background: For patients experiencing ischemic stroke despite receiving therapy with direct oral anticoagulants (DOAC) and without endovascular treatment options, therapeutic prospects are currently dismal. Current guidelines recommend intravenous thrombolysis (IVT) only for patients who have receiv...
Gespeichert in:
| Hauptverfasser: | , , , , , |
|---|---|
| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
September 16, 2024
|
| In: |
Therapeutic advances in neurological disorders
Year: 2024, Jahrgang: 17, Pages: 1-8 |
| ISSN: | 1756-2864 |
| DOI: | 10.1177/17562864241276206 |
| Online-Zugang: | Verlag, kostenfrei, Volltext: https://doi.org/10.1177/17562864241276206 Verlag, kostenfrei, Volltext: https://journals.sagepub.com/doi/10.1177/17562864241276206 
|
| Verfasserangaben: | Antonia Kleeberg, Peter A. Ringleb, Ioana Huber, Jessica Jesser, Markus Möhlenbruch and Jan C. Purrucker |
MARC
| LEADER | 00000caa a2200000 c 4500 | ||
|---|---|---|---|
| 001 | 1917211309 | ||
| 003 | DE-627 | ||
| 005 | 20250716231845.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 250213s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1177/17562864241276206 |2 doi | |
| 035 | |a (DE-627)1917211309 | ||
| 035 | |a (DE-599)KXP1917211309 | ||
| 035 | |a (OCoLC)1528019206 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rda | ||
| 041 | |a eng | ||
| 084 | |a 33 |2 sdnb | ||
| 100 | 1 | |a Kleeberg, Antonia |d 1996- |e VerfasserIn |0 (DE-588)1264253133 |0 (DE-627)181310266X |4 aut | |
| 245 | 1 | 0 | |a Hemorrhagic complications after stroke treatment with intravenous thrombolysis despite use of direct oral anticoagulants |b an observational study |c Antonia Kleeberg, Peter A. Ringleb, Ioana Huber, Jessica Jesser, Markus Möhlenbruch and Jan C. Purrucker |
| 264 | 1 | |c September 16, 2024 | |
| 300 | |a 8 | ||
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Gesehen am 13.02.2025 | ||
| 520 | |a Background: For patients experiencing ischemic stroke despite receiving therapy with direct oral anticoagulants (DOAC) and without endovascular treatment options, therapeutic prospects are currently dismal. Current guidelines recommend intravenous thrombolysis (IVT) only for patients who have received DOAC in very restricted settings, as an increased risk of bleeding is suspected. However, recent retrospective observational studies suggest that IVT is safe despite DOAC pretreatment. - Objectives: To provide further evidence that IVT despite previous DOAC treatment is not associated with an increased risk of bleeding. - Design: Observational retrospective study. - Methods: Demographic, clinical, and radiological data of patients who received IVT (+/− endovascular thrombectomy) despite DOAC pretreatment between June 2021 and January 2024 were analyzed using descriptive statistics, including DOAC plasma concentration at admission. Secondary intracranial hemorrhages and functional outcomes at 3 months were assessed. Since 2023, patients have been treated according to a modified local standard operating procedure at our hospital, allowing for IVT despite DOAC pretreatment regardless of DOAC plasma levels or the use of reversal agents. - Results: Of 1821 patients treated with acute recanalization procedures during the study period, N = 35 had received IVT with (18) or without (17) additional endovascular therapy. Among these patients with a wide age range (42-97 years) and DOAC plasma concentrations up to 369 ng/ml, only one developed symptomatic intracranial hemorrhage. A favorable outcome (modified Rankin scale score 0-2) after 3 months was observed in 57% (20) of the patients. - Conclusion: IVT despite direct oral anticoagulation seems to be safe, even at advanced age and high DOAC plasma levels. | ||
| 700 | 1 | |a Ringleb, Peter A. |e VerfasserIn |0 (DE-588)1032676175 |0 (DE-627)73863364X |0 (DE-576)172917743 |4 aut | |
| 700 | 1 | |a Huber, Ioana |e VerfasserIn |0 (DE-588)1119085691 |0 (DE-627)87237579X |0 (DE-576)479695113 |4 aut | |
| 700 | 1 | |a Jesser, Jessica |d 1983- |e VerfasserIn |0 (DE-588)1084615606 |0 (DE-627)848577663 |0 (DE-576)456376135 |4 aut | |
| 700 | 1 | |a Möhlenbruch, Markus Alfred |d 1979- |e VerfasserIn |0 (DE-588)137693591 |0 (DE-627)594845041 |0 (DE-576)304845655 |4 aut | |
| 700 | 1 | |a Purrucker, Jan |d 1982- |e VerfasserIn |0 (DE-588)142755281 |0 (DE-627)638930405 |0 (DE-576)333199219 |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Therapeutic advances in neurological disorders |d London [u.a.] : Sage, 2008 |g 17(2024), Seite 1-8 |h Online-Ressource |w (DE-627)573753849 |w (DE-600)2442245-9 |w (DE-576)305897357 |x 1756-2864 |7 nnas |a Hemorrhagic complications after stroke treatment with intravenous thrombolysis despite use of direct oral anticoagulants an observational study |
| 773 | 1 | 8 | |g volume:17 |g year:2024 |g pages:1-8 |g extent:8 |a Hemorrhagic complications after stroke treatment with intravenous thrombolysis despite use of direct oral anticoagulants an observational study |
| 856 | 4 | 0 | |u https://doi.org/10.1177/17562864241276206 |x Verlag |x Resolving-System |z kostenfrei |3 Volltext |
| 856 | 4 | 0 | |u https://journals.sagepub.com/doi/10.1177/17562864241276206 |x Verlag |z kostenfrei |3 Volltext |
| 951 | |a AR | ||
| 992 | |a 20250213 | ||
| 993 | |a Article | ||
| 994 | |a 2024 | ||
| 998 | |g 142755281 |a Purrucker, Jan |m 142755281:Purrucker, Jan |d 910000 |d 911100 |d 50000 |e 910000PP142755281 |e 911100PP142755281 |e 50000PP142755281 |k 0/910000/ |k 1/910000/911100/ |k 0/50000/ |p 6 |y j | ||
| 998 | |g 137693591 |a Möhlenbruch, Markus Alfred |m 137693591:Möhlenbruch, Markus Alfred |d 910000 |d 911100 |d 50000 |e 910000PM137693591 |e 911100PM137693591 |e 50000PM137693591 |k 0/910000/ |k 1/910000/911100/ |k 0/50000/ |p 5 | ||
| 998 | |g 1084615606 |a Jesser, Jessica |m 1084615606:Jesser, Jessica |d 910000 |d 911100 |d 50000 |e 910000PJ1084615606 |e 911100PJ1084615606 |e 50000PJ1084615606 |k 0/910000/ |k 1/910000/911100/ |k 0/50000/ |p 4 | ||
| 998 | |g 1119085691 |a Huber, Ioana |m 1119085691:Huber, Ioana |d 910000 |d 911100 |e 910000PH1119085691 |e 911100PH1119085691 |k 0/910000/ |k 1/910000/911100/ |p 3 | ||
| 998 | |g 1032676175 |a Ringleb, Peter A. |m 1032676175:Ringleb, Peter A. |d 910000 |d 911100 |e 910000PR1032676175 |e 911100PR1032676175 |k 0/910000/ |k 1/910000/911100/ |p 2 | ||
| 998 | |g 1264253133 |a Kleeberg, Antonia |m 1264253133:Kleeberg, Antonia |d 910000 |d 911100 |e 910000PK1264253133 |e 911100PK1264253133 |k 0/910000/ |k 1/910000/911100/ |p 1 |x j | ||
| 999 | |a KXP-PPN1917211309 |e 4663974147 | ||
| BIB | |a Y | ||
| SER | |a journal | ||
| JSO | |a {"id":{"doi":["10.1177/17562864241276206"],"eki":["1917211309"]},"physDesc":[{"extent":"8 S."}],"title":[{"subtitle":"an observational study","title":"Hemorrhagic complications after stroke treatment with intravenous thrombolysis despite use of direct oral anticoagulants","title_sort":"Hemorrhagic complications after stroke treatment with intravenous thrombolysis despite use of direct oral anticoagulants"}],"type":{"bibl":"article-journal","media":"Online-Ressource"},"origin":[{"dateIssuedDisp":"September 16, 2024","dateIssuedKey":"2024"}],"relHost":[{"physDesc":[{"extent":"Online-Ressource"}],"id":{"eki":["573753849"],"issn":["1756-2864"],"zdb":["2442245-9"]},"disp":"Hemorrhagic complications after stroke treatment with intravenous thrombolysis despite use of direct oral anticoagulants an observational studyTherapeutic advances in neurological disorders","title":[{"title_sort":"Therapeutic advances in neurological disorders","title":"Therapeutic advances in neurological disorders"}],"type":{"media":"Online-Ressource","bibl":"periodical"},"origin":[{"dateIssuedDisp":"2008-","publisher":"Sage","publisherPlace":"London [u.a.]","dateIssuedKey":"2008"}],"part":{"volume":"17","year":"2024","text":"17(2024), Seite 1-8","extent":"8","pages":"1-8"},"language":["eng"],"pubHistory":["1.2008 -"],"recId":"573753849"}],"language":["eng"],"name":{"displayForm":["Antonia Kleeberg, Peter A. Ringleb, Ioana Huber, Jessica Jesser, Markus Möhlenbruch and Jan C. Purrucker"]},"note":["Gesehen am 13.02.2025"],"recId":"1917211309","person":[{"given":"Antonia","display":"Kleeberg, Antonia","role":"aut","family":"Kleeberg"},{"role":"aut","family":"Ringleb","display":"Ringleb, Peter A.","given":"Peter A."},{"given":"Ioana","display":"Huber, Ioana","family":"Huber","role":"aut"},{"family":"Jesser","role":"aut","given":"Jessica","display":"Jesser, Jessica"},{"display":"Möhlenbruch, Markus Alfred","given":"Markus Alfred","family":"Möhlenbruch","role":"aut"},{"display":"Purrucker, Jan","given":"Jan","role":"aut","family":"Purrucker"}]} | ||
| SRT | |a KLEEBERGANHEMORRHAGI1620 | ||