A 66-year-old with AF on apixaban presents with acute ischemic stroke LKN 45 minutes. NIHSS 16. Last apixaban dose 3 hours ago, normal renal function....

Question

A 66-year-old with AF on apixaban presents with acute ischemic stroke LKN 45 minutes. NIHSS 16. Last apixaban dose 3 hours ago, normal renal function. Thrombolysis?

Accepted Answer

Withhold IV tPA due to recent DOAC; evaluate for thrombectomy

Answer

Give tPA immediately

Answer

Give half-dose tPA

Answer

Give tPA after PCC

Answer

No reperfusion at all

us-abem MCQ (SBA): tPA Contraindication (DOAC)

A 66-year-old with AF on apixaban presents with acute ischemic stroke LKN 45 minutes. NIHSS 16. Last apixaban dose 3 hours ago, normal renal function. Thrombolysis?