Brief Answer:
Holding pradaxa is important for doing the procedure. DO not worry about stroke possibility

Detailed Answer:
Hello,
Thanks for posting in HCM.

Pradaxa is useful to keep your INR up so that it wont cause clot formation and to prevent further episode of any stroke or ischemic attack. But draining of fluid from lung involves inserting needle in lung from outside to drain fluid. If your INR is high there is high chance of bleeding from the procedure which will be equally or more worrisome as that of stroke.

Therefore it is important to hold dabigatran (pradaxa) until the procedure is completed without risk of bleeding. Do not worry, it will be restarted after procedure is done.

I understand you are concerned about stroke development. We had done this procedure on many patients who had similar condition as of yours and were on anticoagulants and we had to hold it for 3-4 days for the procedure or even surgeries. None of them had any episode of stroke or any other thrombo embolic accidents. Therefore I will safely say the chances of untoward events such as stroke or thromboembolic accients after we stop pradaxa for 3-4 days is very, very minimal. I wouldn't be worried about it.
Do not worry. Hold it for 3 days and restart after the procedure is over.

I hope I have answered your query well. If you have any more query kindly write back to me will be happy to help.

Thank you

---