Question

A 63-year-old man with a history of atrial fibrillation on apixaban presents with sudden onset right hemiparesis and aphasia. CT brain shows a large left middle cerebral artery infarct with no haemorrhage. He presented 5 hours after symptom onset. According to Australian stroke guidelines, which of the following is the most appropriate reperfusion strategy?

Accepted Answer

Mechanical thrombectomy if large vessel occlusion is confirmed, despite recent anticoagulation

Answer

Intravenous thrombolysis with alteplase alone

Answer

No reperfusion therapy; start aspirin only

Answer

Immediate reversal of apixaban followed by thrombolysis

Answer

Low molecular weight heparin infusion for reperfusion

Practice question