ArticleEuropean stroke journal2019
European Stroke Organisation Guideline on Reversal of Oral Anticoagulants in Acute Intracerebral Haemorrhage.
Article in European stroke journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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
67 citing papers in PubMed, 7 syntheses or guidelines pooled it, 148 citations in OpenAlex.
- Efficacy and Safety of Andexanet Alfa Versus Four Factor Prothrombin Complex Concentrate for Emergent Reversal of Factor Xa Inhibitor Associated Intracranial Hemorrhage: A Systematic Review and Meta-Analysis.Neurocritical care · 2025Pooled it
- Prothrombin complex concentrate for reversal of oral anticoagulants in patients with oral anticoagulation-related critical bleeding: a systematic review of randomised clinical trials.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Pooled it
- Haemostatic therapies for stroke due to acute, spontaneous intracerebral haemorrhage.The Cochrane database of systematic reviews · 2023Pooled it
- A systematic review and synthesis of global stroke guidelines on behalf of the World Stroke Organization.International journal of stroke : official journal of the International Stroke Society · 2023Pooled it
- Comparison of 3-factor versus 4-factor prothrombin complex concentrate for emergent warfarin reversal: a systematic review and meta-analysis.BMC emergency medicine · 2022Pooled it
- Reporting quality evaluation of the stroke clinical practice guidelines: a systematic review.Systematic reviews · 2021Pooled it
- Pooled it
- Evaluating the Role of Andexanet Alfa in Managing Intracranial Hemorrhage in Patients on Vascular-Dose Rivaroxaban: A Clinical Dilemma.Cardiovascular drugs and therapy · 2026Article
- Beating the clock: comparing the speed of anticoagulation reversal in intracerebral haemorrhage to thrombolysis for acute ischaemic stroke.European stroke journal · 2026Article
- Stroke Action Plan for Europe 2018-2030 (SAP-E): mid-term review and update.European stroke journal · 2026Review
- Feasibility of Direct Oral Anticoagulant Dipstick Point-of-Care Testing in Patients with Acute Stroke and Transient Ischaemic Attack.Cerebrovascular diseases extra · 2026Article
- Acute care of spontaneous intracerebral hemorrhage.Neurological research and practice · 2025Article
- Specific reversal agents for direct oral anticoagulants in neurosurgical emergencies - a systematic review.Research and practice in thrombosis and haemostasis · 2025Review
- Idarucizumab Reversal in Subdural Hemorrhage: A Single-Center Experience.Life (Basel, Switzerland) · 2025Article
- Intracerebral Hemorrhage in Aging: Pathophysiology, Clinical Challenges, and Future Directions.Life (Basel, Switzerland) · 2025Review
- Vitamin K Deficiency: Diagnosis and Management.Annals of laboratory medicine · 2025Review
- Volume Tolerance and Prognostic Impact of Hematoma Expansion in Deep and Lobar Intracerebral Hemorrhage.Stroke · 2025Article
- Principles of reversal of anticoagulation in patients with intracerebral hemorrhage related to oral anticoagulants.European stroke journal · 2025Review
- Reversal of anticoagulation in patients with intracerebral haemorrhage related to oral anticoagulants: State of the evidence.European stroke journal · 2025Review
- Intersections and Challenges in the Management of Acute Coronary Syndrome and Stroke: Pathophysiology, Treatment Dilemmas, and Integrated Prevention Strategies.Journal of clinical medicine · 2025Review
7 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 8 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The aim of the present European Stroke Organisation guideline document is to provide clinically useful evidence-based recommendation on reversal of anticoagulant activity VKA (warfarin, phenprocoumon and acenocoumarol), direct factor II (thrombin) inhibitors (dabigatran etexilat) and factor-Xa-inhibitors (apixaban, edoxaban and rivaroxaban) in patients with acute intracerebral haemorrhage. The guideline was prepared following the Standard Operational Procedure for a European Stroke Organisation guideline document and according to GRADE methodology. As a basic principle, we defined use of oral anticoagulation pragmatically: oral anticoagulation use is assumed by positive medical history unless relevant anticoagulant activity is regarded unlikely by medical history or has been ruled out by laboratory testing. Overall, we strongly recommend using prothrombin complex over no treatment and fresh-frozen plasma in patients on VKA plus vitamin K. We further strongly recommend using idarucizumab in patients on dabigatran and make a recommendation for andexanet alfa in patients on rivaroxaban and apixaban over no treatment. We make a weak recommendation on using high-dose prothrombin complex concentrate (50 IU/kg) for all patients taking edoxaban and for patients on rivaroxaban or apixaban in case andexanet alfa is not available. We recommend against using tranexamic acid and rFVIIa, outside of trials. The presented treatment recommendations aim to normalise coagulation, there is no or only indirect data on effects on functional outcome or mortality, and only little data from randomised controlled trials.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.