Safety of Intravenous Thrombolysis Among Patients Taking Direct Oral Anticoagulants

A Systematic Review and Meta-Analysis

Shima Shahjouei, MD, MPH; Georgios Tsivgoulis, MD, PhD, MSc, FESO; Nitin Goyal, MD; Alireza Sadighi, MD; Ashkan Mowla, MD; Ming Wang, MS, PhD; David J. Seiffge, MD; Ramin Zand, MD, MPH


Stroke. 2020;51(2):533-541. 

In This Article


The results of our study indicate that prior intake of DOACs within 48 hours of tPA bolus is not associated with an increased risk of symptomatic hemorrhagic transformation in selected AIS patients. Due to small sample size, lack of randomization and inadequate data regarding the exact time of last DOACs intake, further studies are required before generalizing the result of this review.