Table 1

Summary of observational studies with >10 patients describing reperfusion therapy in patients on DOAC

Author, yearDOACIntravenous thrombolysis (IVT)Endovascular thrombectomy (EVT)
nStrategy for IVTsICH n(%)nProportion receiving IVTEVT success (TICI2B-3)sICH n(%)Comments
Rebello 201525 Dabigatran, rivaroxaban, apixaban17Not reported14 (82%)Not reported. 2 (11%) patients had parenchymal haemorrhage type 1, none had type 2.
Seiffge 201521 All51Partly plasma level based but heterogeneous selection criteria2 (4.0%)336Not reported0
Purrucker 201626 Dabigatran, rivaroxaban, apixaban5Not specified but likely based drug specific activity1 (20%)285 (17.9%)16 (57%)1 (3.6%)Primary EVT analysis. The patient with SICH had received IVT and EVT (vessel perforation)
Xian 201727 Dabigatran, rivaroxaban, apixaban251Not reported12 (4.8%)
Kurowski 201715 Dabigatran, rivaroxaban, apixaban200Not reported0
Suzuki 201728 All71INR ≤1.7, APTT <40 s04415/44Not reported2/44
Chen 201729 Rivaroxaban10Not reported0
Wong 201817 Dabigatran, Rivaroxaban, Apixaban130Not specifically reported0Included only IVT ineligible patients
Černík 201816 Not reported15Not reported11/15 (73%)0
Hoyer 201830 Not reported8Not reported010Not reportedNot reported0
Pretnar Oblak 201831 Dabigatran11Idarucizumab reversal1 (9.1%)
Šaňák 201832 Dabigatran13Idarucizumab reversal1 (7.7%)11 (100%)Not reportedPrimary IVT paper
Fang 201933 Dabigatran10Idarucizumab reversal1 (10%)11 (100%)Not reported0Primary IVT paper
Marsch 201924 All24Drug-specific plasma level (<50 to 100 ng/mL) used for selection. Excluded patients with idarucizumab reversal1 (4.2%)1714 (82.3%)16/17 (94.1%)1 (5.9%)
Ramos-Araque 202034 Not reported3Not reportedNot reported81372/72 (88.9%)1 (1.2%)
Barber 202035 Dabigatran51Idarucizumab reversal2 (3.9%)88 (100%)Not reported1 (12.5%)Primary IVT paper
Beharry 202036 Dabigatran13Idarucizumab reversal077Not reported0Primary IVT paper Tenecteplase
Kermer 202037 Dabigatran80Idarucizumab reversal077Not reported0Primary IVT paper
Meinel 202038 All7Not reportedNot reported987 (7.1%)68/98 (69.4%)5 (4.5%)Primary EVT paper
Küpper14 2020All91Not availableAny ICH at 24 hours 11%82791701/822 (85.3%)97 (11.7%)
L’Allinec 202039 Dabigatran, Rivaroxaban, Apixaban115Excluded from report103/112 (92%)6/105 (5.7%)
Goldhoorn 202018 Not reported98Not reported specifically for DOAC subgroup56/86 (65%)1/98 (1%)vs 6% SICH in warfarin
MR CLEAN Registry
Meinel 202138 All69Mainly based on drug-specific coagulation assays2 (3.1%)170N/AN/A2/170 (1.3%)
  • Due to overlapping patients, data on IVT and EVT are listed separately.

  • mTICI, modified thrombolysis in cerebral infarction score.

  • DOAC, direct oral anticoagulant; ICH, intracranial haemorrhage; N/A, not available; SICH, symptomatic intracranial haemorrhage.