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In this study, we explore its use in an experimental model of traumatic brain injury (TBI), mimicking a closed head trauma under rivaroxaban-induced anticoagulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Male C57BL6 mice were fed with rivaroxaban (10\u00a0mg\/kg body weight). Subsequently, TBI was induced by controlled cortical impact (CCI) and andexanet\u00a0alfa or placebo were administered as intravenous bolus injections. Edema and hemorrhage volume was quantified by magnetic resonance imaging (MRI) 24\u00a0h and 7\u00a0days after CCI. Functional outcome was assessed at day 1, 3, and 7 thereafter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Andexanet\u00a0alfa led to reduced hemorrhage volume 24\u00a0h and 7\u00a0days after CCI as compared with control group without reversal of anticoagulation (2.9\u2009\u00b1\u20091.4\u00a0\u00b5l vs. 5.2\u2009\u00b1\u20093.3\u00a0\u00b5l,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02; 3.4\u00a0\u00b5l\u2009\u00b1\u20091.5\u00a0\u00b5l vs. 5.5\u00a0\u00b5l\u2009\u00b1\u20092.4\u00a0\u00b5l,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). Along with the smaller hematoma sizes in the MRI, edema volume was significantly lower in mice treated with andexanet\u00a0alfa 24\u00a0h and 7\u00a0days after CCI (\u22126.3% of contralateral hemisphere,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0002; and\u2009\u22127.1% of contralateral hemisphere,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). While functional outcomes did not differ at 24\u00a0h following TBI, andexanet\u00a0alfa improved neurological deficits after 7\u00a0days.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our experimental data suggests that the use of andexanet\u00a0alfa improves functional outcomes by reduction of factor Xa inhibitor\u2013associated hematoma expansion in the subacute phase following TBI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12028-026-02463-w","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T21:50:14Z","timestamp":1772574614000},"page":"200-207","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Andexanet\u00a0alfa Reduces Hematoma Expansion Following Controlled Cortical Impact in Mice Pretreated with Rivaroxaban"],"prefix":"10.1007","volume":"45","author":[{"given":"Franziska","family":"Lieschke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Gelhard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Rosenthal-Rueckeis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Grefkes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6439-0667","authenticated-orcid":false,"given":"Ferdinand O.","family":"Bohmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"issue":"1-2","key":"2463_CR1","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1159\/000471877","volume":"48","author":"W Peeters","year":"2017","unstructured":"Peeters W, Majdan M, Brazinova A, Nieboer D, Maas AIR. 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Ferdinand Bohmann reports speakers\u2019 honoraria from Laerdal, AstraZeneca, Bristol-Myers-Squibb, Pfizer, Medtronic and grants and personal fees from Alexion, Stryker Neurovascular, Boehringer Ingelheim. All other authors have nothing to declare.","order":1,"name":"Ethics","label":"Conflicts of Interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All animal experiments were prospectively approved by the research ethics committee and continuously monitored (Regierungspraesidium Darmstadt, approval number FU\/2054).","order":2,"name":"Ethics","label":"Ethical Approval\/Informed Consent","group":{"name":"EthicsHeading","label":"Declarations"}}]}}