Reversal of Dabigatran with Idarucizumab in Acute Subarachnoid Hemorrhage

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" Reversal of Dabigatran with Idarucizumab in Acute Subarachnoid Hemorrhage "
Balakumar, Jonathan; Santiago, Ruben; Supino, Mark

Document Type	:	AL
Record Number	:	927880
Doc. No	:	LA7sj047ms
Language of Document	:	English
Main Entry	:	Balakumar, Jonathan; Santiago, Ruben; Supino, Mark
Title & Author	:	Reversal of Dabigatran with Idarucizumab in Acute Subarachnoid Hemorrhage [Article]\ Balakumar, Jonathan; Santiago, Ruben; Supino, Mark
Title of Periodical	:	Clinical Practice and Cases in Emergency Medicine
Volume/ Issue Number	:	1/4
Date	:	2017
Abstract	:	Dabigatran etexilate mesylate is a direct thrombin inhibitor used for reducing the risk of stroke andsystemic embolism in patients with non-valvular atrial fibrillation. Dabigatran belongs to a new generationof oral agents for anticoagulation – the direct oral anticoagulants (DOACs). The DOACs also includethe factor Xa inhibitors rivaroxaban, apixaban, and edoxaban. In the case of major or life-threateningbleeding and/or the need for emergent invasive procedures, a reversal agent is needed if a patient istaking one of these medications. Research has shown the efficacy of idarucizumab as an antidote inhealthy volunteers, but data in the case of life-threatening bleeds remains limited. We report a caseof a patient who suffered a traumatic subarachnoid hemorrhage and received effective treatment withidarucizumab. Along with other reports, our case demonstrates that dabigatran-related major and/orlife-threatening bleeds may be effectively counteracted by idarucizumab. This provides an option toemergency department providers in managing clinically significant bleeds in patients taking dabigatran.