When is early anticoagulation with heparin indicated for prevention of recurrent posterior cerebral artery (PCA) stroke?

Updated: Jul 30, 2018
  • Author: Erek K Helseth, MD; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Anticoagulation is infrequently indicated in the acute phases of posterior cerebral artery (PCA) stroke. While historically, early anticoagulation (generally with heparin infusion) has been used in acute stroke, significant supporting data have been absent.

Indeed, early anticoagulation, particularly with heparin, has been studied in a number of diagnostic settings but has not been demonstrably proven to be beneficial. Cochrane reviews of studies totaling more than 20,000 patients have suggested that early anticoagulation does not produce a mortality or morbidity benefit. [22, 23] In specific cases (large vessel, high-grade stenosis), some benefit may have been seen; however, this was offset by increased hemorrhagic complications.


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