[Heparin in acute cerebral ischemia]

Non fractionated heparin is used in neurovascular disease because of its antithrombolytic action. Therefore, the design of the clinical studies performed to date has emphasized these actions. However, the results obtained in the most recent clinical studies have been discouraging, not only because they have demonstrated its lack of efficacy, but also because the use of this heparin has been followed by an excessive number of complications. This article provides critical comments on the possible causes of these results and underlines the most recent advances obtained in the knowledge of the mechanism of action of this drug. Particularly, its potential antiinflammatory role is emphasized as are the experimental requisites required for this antiinflammatory action to be fully expressed. Based on the results shown it is concluded that it is necessary to prospectively evaluate the role of heparin in acute ischemic ictus.