Javed Anees: When and Whether to Restart a DOAC after Spontaneous ICH
Javed Anees, Medical Consultant at Government of Kerala, shared a post on LinkedIn:
“Anticoagulation after spontaneous intracerebral hemorrhage remains one of the most challenging decisions in stroke practice – balancing recurrent hemorrhage risk against prevention of ischemic stroke and systemic embolism.
This infographic summarizes a practical approach to deciding whether and when to restart anticoagulation, with emphasis on:
- Deep hypertensive vs lobar and CAA-related ICH
- Timing of anticoagulation resumption
- Mechanical valve and very high thromboembolic-risk exceptions
- Repeat CT or MRI and cerebral microbleed assessment
- Importance of strict blood pressure control
- DOAC versus VKA selection
- Evidence from SoSTART, APACHE-AF, NASPAF-ICH and PRESTIGE-AF
- Role of left atrial appendage occlusion
- A stepwise Neurology – Cardiology shared-decision algorithm
A key principle is that there is no universal restart date. In selected patients with non-valvular atrial fibrillation, anticoagulation is commonly reconsidered within 4–8 weeks, often around 7–8 weeks, but the final decision must integrate hemorrhage phenotype, thromboembolic indication, blood pressure control, imaging markers and individual patient risk.”
Other posts featuring Javed Anees on Hemostasis Today.
-
Jul 22, 2026, 20:51Anu Thomas: ET vs IUT – Two Life-Saving Procedures, Different Stages of Care
-
Jul 22, 2026, 20:49Gerard J. Myers: Why Do Clinicians Ignore The Potential Morbidity Associated With IV Air and The Effects of VAE?
-
Jul 22, 2026, 20:47Phillip Smith: The Woman Who Was Told She Couldn’t Have Hemophilia
-
Jul 22, 2026, 20:45David McIntosh: Artificial Blood Will Require More Blood Donation, Not Less
-
Jul 22, 2026, 20:04Maria Cherska: Why Female Vascular Biology Matters for Precision Cardiometabolic Medicine
-
Jul 22, 2026, 19:27Alexandra Yakusheva: Stepping Into Senior Authorship – Our New Paper is Out!
-
Jul 22, 2026, 18:31Clivaz Léa: Presenting Research on Pregnancy-Related Pulmonary Embolism at ISTH 2026
-
Jul 22, 2026, 18:18Mohammed Alo: Arteries And Veins Are Structurally Built For Different Jobs
-
Jul 22, 2026, 18:14Luke Blount: Reflecting on an Inspiring ISTH 2026 Congress