Purpose of review: Venous thromboembolism is an important cause of morbidity and mortality after stroke. Its potential for prevention is substantial with the use of antithrombotic agents, but there is no agreement on the relative advantages and disadvantages of various available prophylactic drugs. There have been recent publications that clarify some of these issues.
Recent findings: Data from recently published controlled clinical trials have added to our understanding of the risk-benefit ratio of the two most commonly used antithrombotics: unfractionated heparin and low-molecular-weight heparins. These data suggest that the low-molecular-weight heparin enoxaparin has a superior clinical profile in comparison with unfractionated heparin.
Summary: Antithrombotic agents are the mainstay in the prevention of venous thromboembolism after stroke. The highly effective unfractionated heparin and low-molecular-weight heparins may have a different clinical profile that could have a substantial impact in clinical practice.