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Open Trial With Continuous Intravenous Heparinization

Manuel Ramirez-Lassepas, MD; Mario R. Quiñones, MD; Henry H. Nino, MD

Arch Neurol. 1986;43(4):386-390.

Abstract
• To determine safety of early anticoagulation in patients with acute ischemic stroke, 150 consecutive patients were treated with continuous intravenous heparinization for one to 17 days (median, seven days) in an open trial. Fourteen patients had transient ischemic attacks and 136 patients had acute cerebral infarctions (Cls). None of the patients with transient ischemic attacks experienced untoward events. Of those with acute CI, four patients (3%) suffered a new, or extension of, CI; six patients (4.4%) suffered hemorrhagic complications, four patients (3%) died during treatment, and six patients (4%) died afterwards. Three of the deaths were related to treatment complications. Only 13 patients (8.6%) experienced fluctuation of deficit. Median hospitalization was 25.5 days. Recovery of function was good to excellent in 81% of the patients with acute CI; 75% of the survivors were ambulatory, and about 66% of the patients had either a mild or a minimal neurologic deficit at discharge. The incidence of untoward events in patients with acute CI was high enough (7.4%) for us to conclude that the efficacy of continuous intravenous heparinization in acute ischemic stroke should be established with controlled studies before its routine use can be recommended.

Author Affiliations
From the Department of Neurology, St Paul-Ramsey Medical Center (Drs Ramírez-Lassepas, Quiñones, and Nino), and the Department of Neurology, University of Minnesota School of Medicine, Minneapolis (Dr Ramírez-Lassepas).

Footnotes
Accepted for publication Sept 10, 1985.

Reprint requests to Department of Neurology, St Paul-Ramsey Medical Center, St Paul, MN 55101 (Dr Ramírez-Lassepas).

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