Would you favor restarting anticoagulation or pursuing left atrial appendage closure in a patient with hemorrhagic stroke on anticoagulation for non-valvular atrial fibrillation?
Answer from: at Academic Institution
That is a great question, thank you for bringing it up. The answer really depends on the likely etiology of the intracerebral hemorrhage. For example, if the hemorrhage is subcortical and the etiology is thought to be likely related to hypertension, it is reasonable to resume anticoagulation when sa...
Comments
at Yale University Great response @Shadi Yaghi. I was on call yesterd...
at Stormont Vail Hospital Thank you for that explanation @Shadi Yaghi. What ...
at UPMC Are there a number of microhemorrhages over which ...
at Brown University Medical School These are great questions. There is limited data o...
One of my strategies of staying practical is working from treatment backwards.
I believe the folks who get the left atrial appendage closure post-op are immediately placed on warfarin + antiplt and or dual antiplt and or NOAC + antiplt.
Warfarin + antiplt / NOAC + antiplt has been strongly discour...
If the anticoagulant was warfarin, and the INR was supratherapeutic, starting warfarin with a lower INR goal or substituting a DOAC would make sense. If on a DOAC already, I would strongly consider LAA closure. If there is evidence of a Cerebral Amyloid Angiopathy related bleed, then I would move to...
Great response @Shadi Yaghi. I was on call yesterd...
Thank you for that explanation @Shadi Yaghi. What ...
Are there a number of microhemorrhages over which ...
These are great questions. There is limited data o...