Stroke thrombolysis in patients taking dabigatran

Stroke thrombolysis is becoming a common practice in Australian and New Zealand hospitals. There are no established guidelines for thrombolysis of patients who are taking dabigatran, and accurate medication reconciliation may not be possible. Patients with normal activated partial thromboplastin time are unlikely to have clinically significant dabigatran concentration in the blood. For safest outcomes, we suggest incorporating thrombin time assay for acute stroke patients suspected to be taking dabigatran.