Introduction: At present date, 14 randomized endovascular trials for acute ischemic stroke have been published with more recent trials demonstrating a benefit of endovascular therapy. Heparin use during the endovascular procedure is a potential confounder of patient outcome. We sought to describe and highlight differences in the heparin protocols of the major endovascular trials.
Hypothesis: We hypothesized that heparin protocols would differ among endovascular stroke trials.
Methods: We reviewed the heparin protocol from the methods section of 14 endovascular trials for acute ischemic stroke. In studies where the protocol was not included in the methods section or the appendix of a manuscript, the principal investigator of the trial was contacted to provide insight into the use of heparin during the study.
Results: No two of the major endovascular stroke trials used the same heparin protocol. Table 1 details the variability in the protocols. In cases where heparin dosing was not discussed, we left the study “N/A” in the table.
Conclusion: Although numerous endovascular ischemic stroke trials have been conducted, heparin use and its documentation during the procedure have varied greatly over the past 20 years. Heparin, an anticoagulant, could contribute to either increased bleeding or improved clot removal and maintenance of recanalization. Future studies of the role of adjunctive antithrombotic therapy during endovascular therapy are needed, and heparin use in these protocols should be specifically detailed and ideally standardized.