Question

A 74-year-old woman with atrial fibrillation and a recent ischaemic stroke is being evaluated for IV alteplase at 2.5 hours after onset. She took apixaban 2 hours ago. What is the best course of action?

Accepted Answer

Do not give alteplase due to recent DOAC use

Answer

Proceed with alteplase

Answer

Lower BP only and then give alteplase

Answer

Administer reversal and give alteplase routinely

Answer

Give heparin infusion instead

Practice question

A 74-year-old woman with atrial fibrillation and a recent ischaemic stroke is being evaluated for IV alteplase at 2.5 hours after onset. She took apixaban 2 hours ago. What is the best course of action?