{"pk":452,"title":"Reversal of Dabigatran with Idarucizumab in Acute Subarachnoid Hemorrhage","subtitle":null,"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.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7sj047ms","frozenauthors":[{"first_name":"Jonathan","middle_name":"","last_name":"Balakumar","name_suffix":"","institution":"Jackson Memorial Hospital, Department of Emergency Medicine, Miami, Florida","department":"None"},{"first_name":"Ruben","middle_name":"","last_name":"Santiago","name_suffix":"","institution":"Jackson Memorial Hospital, Department of Emergency Medicine, Miami, Florida","department":"None"},{"first_name":"Mark","middle_name":"","last_name":"Supino","name_suffix":"","institution":"Jackson Memorial Hospital, Department of Emergency Medicine, Miami, Florida","department":"None"}],"date_submitted":"2017-10-06T12:40:41-04:00","date_accepted":"2017-10-06T12:40:41-04:00","date_published":"2017-10-06T12:41:05-04:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/452/galley/216/download/"}]}