ArticleJournal of stroke2018
Consensus Guides on Stroke Thrombolysis for Anticoagulated Patients from Japan: Application to Other Populations.
Article in Journal of stroke, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Intravenous Thrombolysis for Acute Ischemic Stroke in Patients With Recent Direct Oral Anticoagulant Use: A Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2023Pooled it
- Safety and efficacy of intravenous thrombolysis in patients with acute ischemic stroke taking direct oral anticoagulants prior to stroke: a meta-analysis.Journal of neurology · 2023Pooled it
- Mechanical Thrombectomy for Acute and Subacute Blocked Arteries and Veins in the Lower Limbs: A Health Technology Assessment.Ontario health technology assessment series · 2023Pooled it
- Guidelines for Intravenous Thrombolysis (Recombinant Tissue-type Plasminogen Activator), the Third Edition, March 2019: A Guideline from the Japan Stroke Society.Neurologia medico-chirurgica · 2019Guideline
- Development of tenecteplase for stroke thrombolysis: Japan's endeavor.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Review
- Intravenous thrombolysis for acute cerebral embolism during atrial fibrillation ablation: a case report and systematic review with meta-analysis.Frontiers in cardiovascular medicine · 2026Review
- Anesthesia Considerations in Older Adults Undergoing Emergency Mechanical Thrombectomy for Acute Ischaemic Stroke.Drugs & aging · 2025Review
- Article
- Impact of Direct Oral Anticoagulant Levels on Functional Independence Following Endovascular Thrombectomy in Patients With Atrial Fibrillation.Stroke (Hoboken, N.J.) · 2024Article
- Idarucizumab for Emergency Reversal of the Anticoagulant Effects of Dabigatran: Final Results of a Japanese Postmarketing Surveillance Study.Cardiology and therapy · 2023Article
- Standard operating procedure for idarucizumab reversal of dabigatran anticoagulation in ischemic and hemorrhagic stroke.Journal of thrombosis and thrombolysis · 2023Review
- Development and refinement of diagnostic and therapeutic strategies for managing patients with cardiogenic stroke: An arduous journey.World journal of clinical cases · 2023Review
- Intravenous Thrombolysis With Alteplase at 0.6 mg/kg in Patients With Ischemic Stroke Taking Direct Oral Anticoagulants.Journal of the American Heart Association · 2022Observational
- Recanalisation therapies for acute ischaemic stroke in patients on direct oral anticoagulants.Journal of neurology, neurosurgery, and psychiatry · 2021Review
- European Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke.European stroke journal · 2021Article
- Idarucizumab for Emergency Reversal of Anticoagulant Effects of Dabigatran: Interim Results of a Japanese Post-Marketing Surveillance Study.Cardiology and therapy · 2020Article
- MRI characteristics in acute ischemic stroke patients with preceding direct oral anticoagulant therapy as compared to vitamin K antagonists.BMC neurology · 2020Article
- Successful thrombolytic therapy with recombinant tissue plasminogen activator in ischemic stroke after idarucizumab administration for reversal of dabigatran: a case report.Journal of medical case reports · 2019Article
- Stroke severity in patients with preceding direct oral anticoagulant therapy as compared to vitamin K antagonists.Journal of neurology · 2019Observational
- Small but Steady Steps in Stroke Medicine in Japan.Journal of the American Heart Association · 2019Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
Development of direct oral anticoagulants and their antidotes has led to the need to reconsider the eligibility of acute stroke patients who have been taking oral anticoagulants for intravenous thrombolysis. Officially authorized Japanese guidelines on this issue were revised twice at the time of approval for clinical use of direct oral anticoagulants and idarucizumab, a specific reversal agent for dabigatran. A unique recommendation in the latest Japanese clinical guides was that thrombolysis can be recommended if the time of the last dose of direct oral anticoagulants exceeds 4 hours and if commonly available anticoagulation markers are normal or subnormal, i.e., international normalized ratio of prothrombin time <1.7 and activated partial thromboplastin time <1.5 times the baseline value (≤40 seconds only as a guide). These criteria are partly supported by the findings of domestic multicenter and single-center surveys that symptomatic or asymptomatic intracranial hemorrhage following thrombolysis was rare under the conditions of the criteria. Even for dabigatran users, stroke thrombolysis can be considered without pretreatment by idarucizumab if patients meet the above criteria. If not, direct mechanical thrombectomy can be considered without pretreatment by idarucizumab or thrombolysis, and use of idarucizumab, followed immediately by thrombolysis, can be considered only when thrombectomy cannot be quickly performed. These clinical guides are practical and to some extent economical, but they have some limitations, including lack of corroborating information from sufficient numbers of relevant cases. The guides will be further modified based on the results of future research.
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