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Related Concept Videos

Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
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Updated: Jul 15, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

[Antithrombotic therapy in acute ischemic stroke].

Shinichiro Uchiyama1

  • 1Department of Neurology, Tokyo Women's Medical University School of Medicine.

Rinsho Shinkeigaku = Clinical Neurology
|April 17, 2007
PubMed
Summary

Antithrombotic therapy prevents clot spread in brain arteries, not vessel reopening. Current evidence suggests limited benefit from heparin, with warfarin preferred for specific stroke types and atrial fibrillation.

Area of Science:

  • Neurology
  • Cardiology
  • Pharmacology

Context:

  • Antithrombotic therapy is crucial for managing cerebrovascular diseases.
  • Understanding the efficacy and safety of different antithrombotic agents is essential for stroke prevention and treatment.
  • Current therapeutic strategies aim to prevent thrombus propagation and reocclusion in cerebral arteries.

Purpose:

  • To review the current evidence on antithrombotic therapies for stroke.
  • To evaluate the role of anticoagulants like heparin and warfarin in specific stroke subtypes.
  • To assess the efficacy and safety of antiplatelet agents, including aspirin and GP IIb/IIIa inhibitors.

Summary:

  • Heparin and heparinoids show no proven long-term benefit for stroke outcomes, though anticoagulation may be indicated for specific conditions like progressing stroke or cardioembolic stroke.

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  • Warfarin is recommended for nonvalvular atrial fibrillation patients, particularly avoiding immediate heparin in large hemispheric strokes.
  • Aspirin offers modest efficacy, while more potent agents like abciximab have raised safety concerns; dual antiplatelet therapy trials are ongoing.

    • Impact:

    • Provides a concise overview of antithrombotic therapy in stroke management.
    • Highlights the nuanced indications for anticoagulants and antiplatelet agents.
    • Informs clinical decision-making regarding the optimal use of antithrombotic strategies for stroke prevention and treatment.