RISK OF IMMEDIATE HEPARIN AFTER RT-PA THERAPY IN ACUTE ISCHEMIC STROKE

The efficacy of rt-PA treatment within 3 h in patients with acute isch emic stroke was recently demonstrated in two large, double-blind, rand omized trials. The role of postthrombolytic heparin therapy in stroke still remains unclear as anticoagulation was not allowed during the fi rst 24 h in most larger studies, The risk of combining thrombolytic wi th immediate anticoagulant therapy was e-valuated in 43 consecutive pa tients with acute stroke, Thrombolysis (NINDS protocol) was followed b y intravenous heparin aiming to double aPTT, Clinical course and CT we re assessed after 24 h for signs of intracranial bleeding, The data of our series were compared to those of the present literature, Hemorrha gic conversion was found in 9 patients (21%), only one elf them had sy mptomatic parenchymal hematoma (2.3%). In this small, open study the r isk of symptomatic hemorrhagic complication after combined therapy doe s not seem to be markedly greater than after thrombolysis alone.