Hazards of Aspirin and Heparin During Acute Stroke Thrombectomy

A randomized trial showed no benefits and higher rates of symptomatic hemorrhage with both drug treatments.

The periprocedural use of antithrombotic agents during endovascular thrombectomy (EVT) for acute ischemic stroke is not standardized. Some practitioners administer aspirin or intravenous (IV) heparin, a practice that has not been well studied. These investigators conducted a randomized trial of patients undergoing EVT for acute ischemic stroke within 6 hours after stroke onset. Patients were randomly assigned to aspirin (300 mg) or no aspirin. They were also randomized to either no heparin or one of two different unfractionated heparin regimens: moderate dose, consisting of a 5000 IU bolus followed by 1250 IU/hour for 6 hours; or low dose, consisting of the same bolus dose followed by 500 IU/hour for 6 hours. The primary outcome was the mod…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Hazards of Aspirin and Heparin During Acute Stroke Thrombectomy

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Reviewing Author