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Non‐contrast CT Markers of Hematoma Expansion and Andexanet Response in Factor Xa Inhibitor‐Associated Intracerebral Hemorrhage: An Analysis from ANNEXa ‐I Trial

Abstract

In this post hoc analysis of the ANNEXa‐I trial (n = 434), we evaluated non‐contrast computed tomography (NCCT) markers of hematoma expansion (HE) in factor Xa inhibitor (FXai) –associated intracerebral hemorrhage (ICH). At least one NCCT marker was present in 72.1%, and HE (≥12.5 mL or ≥ 35% increase in hematoma volume) occurred in 31.8%. Heterogeneous density, hypodensity, and the black hole sign were independently associated with HE. The effect of andexanet on HE was generally consistent across NCCT marker subgroups. These findings support the utility of NCCT markers for identifying patients at high risk of HE in FXai‐associated ICH. ANN NEUROL 2026

Authors

Tanaka K; Pensato U; Alshamrani M; Katsanos AH; Balali P; Ray S; Kasner SE; Beyer‐Westendorf J; Toni D; Seiffge DJ

Journal

Annals of Neurology, , ,

Publisher

Wiley

Publication Date

September 8, 2026

DOI

10.1002/ana.78347

ISSN

0364-5134

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