title: Oral anticoagulants - a frequent challenge for the emergency management of acute ischemic stroke
creator: Rizos, Timolaos
creator: Horstmann, Solveig
creator: Jenetzky, Ekkehart
creator: Spindler, Marcia
creator: Gumbinger, Christoph
creator: Möhlenbruch, Markus
creator: Ringleb, Peter
creator: Hacke, Werner
creator: Veltkamp, Roland
subject: ddc-610
subject: 610 Medical sciences Medicine
description: Background: The emergency management of patients with acute ischemic stroke (IS) using oral anticoagulants (OAC) represents a great challenge. Effective anticoagulation predisposes to bleeding and represents a contraindication for systemic thrombolysis. However, patients on OAC can receive intravenous thrombolysis with recombinant tissue-type plasminogen activator if the international normalized ratio (INR) does not exceed 1.7, but data regarding the risk of hemorrhagic complications are highly controversial. Neurointerventional recanalization of intracranial artery occlusion represents an alternative option in OAC patients with acute IS. The proportion of OAC users among consecutive patients who suffer from acute IS or transient ichemic attacks (TIA) is unknown. Methods: A prospective observational study, consecutively enrolling all patients with IS or TIA admitted to our neurological emergency room (ER), was performed between August 2009 and February 2011. Basic demographic variables, present use of OAC, severity of stroke, cardiovascular risk factors, INR values and the symptom onset to presentation time were recorded. In IS patients on OAC presenting within 4.5 h after symptom onset, management was analyzed. In thrombolysed IS patients, bleeding events were documented. Outcome was assessed after 3 months.
publisher: S. Karger AG
date: 2012
type: Article
type: info:eu-repo/semantics/article
type: NonPeerReviewed
format: application/pdf
identifier: https://archiv.ub.uni-heidelberg.de/volltextserver/17801/1/CED20120345-6411.pdf
identifier: DOI:10.11588/heidok.00017801
identifier: urn:nbn:de:bsz:16-heidok-178016
identifier:   Rizos, Timolaos ; Horstmann, Solveig ; Jenetzky, Ekkehart ; Spindler, Marcia ; Gumbinger, Christoph ; Möhlenbruch, Markus ; Ringleb, Peter ; Hacke, Werner ; Veltkamp, Roland  (2012) Oral anticoagulants - a frequent challenge for the emergency management of acute ischemic stroke.  Cerebrovascular diseases, 34 (5-6).  pp. 411-418.  ISSN 1015-9770     
relation: https://archiv.ub.uni-heidelberg.de/volltextserver/17801/
rights: info:eu-repo/semantics/openAccess
rights: http://archiv.ub.uni-heidelberg.de/volltextserver/help/license_urhg.html
language: eng