Abstract 2851: Intravenous Heparin For The Treatment Of Intraluminal Thrombus In Patients With Acute Ischemic Stroke
Background and objectives: Current American Stroke Association/American Heart Association recommendations on the management of acute ischemic stroke do not recommend early use of heparin owing to increased risk of bleeding complications. However, for select patients, such as those with strokes associated with intraluminal thrombus, intravenous (IV) heparin might prove to be beneficial.
Methods: We conducted a retrospective analysis of acute ischemic stroke cases associated with intraluminal thrombus of intracranial and extracranial arteries in the corresponding vascular territories to identify patients in whom treatment with IV heparin resulted in near-complete or complete lysis of the thrombus. Imaging findings from computed tomographic (CT) perfusion and angiography, magnetic resonance imaging, and/or digital subtraction angiography were used to describe the location of intraluminal thrombus immediately before and after treatment with IV heparin.
Results: Eighteen patients with confirmed intraluminal thrombus by CT angiography (CTA) received treatment with IV heparin alone (median duration 3.5 days; range 1-8 days). The median NIHSS score was 2.5 (range 0-15) on admission and 1 (range 0-9) at discharge. Nine patients had complete lysis, and 9 patients had partial lysis of the thrombus with improved flow distal to the location of the thrombus. None of the patients developed intracranial hemorrhage.
Conclusion: For strokes associated with intraluminal thrombus, IV heparin might prove to be an effective treatment strategy. Further studies are necessary to evaluate the efficacy and safety of treatment with IV heparin in those patients.
- © 2012 by American Heart Association, Inc.