Heparin is the only antithrombotic drug whose efficacy has been uniquivocally established *by controlled prospective studies. The premise of heparin therapy, whether the drug is given by intravenous or subcutaneous routes of administration is the same: that by accelerating the inactivation of activated clotting factors the deposition or growth of stasis thrombi is inhibited. The major complication of heparin therapy, bleeding, can be reduced but not prevented by close attention to details of administration and monitoring. Thrombocytopenia, another complication of heparin, may be more frequent than previously suspected. Osteoporosis, a consequence of long-term, high-dose heparin administration, occurs when doses in excess of 10,000 units/day are administered for more than a few months. Properly given and monitored, heparin remains the standard against which all other forms of antithrombotic therapy should be measured.
Safety and Efficacy of Fixed-dose Heparin in Carotid Endarterectomy
