Patients presenting with an acute ischemic stroke despite dabigatran therapy (last intake <24 h or unknown) should be evaluated for reversal by idarucizumab, making them eligible for safe and effective intravenous thrombolysis. It has been shown to be feasible, well-tolerated, and easy to manage in an emergency room or stroke unit.
Binet, Q., Hammer, F., Rocrelle, O., Peeters, A., Scavée, C., & Hermans, C. (2018). Systemic thrombolysis and endovascular thrombectomy in severe acute ischemic stroke after dabigatran reversal with idarucizumab. Clinical Case Reports, 6(4), 698-701. https://doi.org/10.1002/ccr3.1446 (Original work published 2018)