Table 5.
Available Hemostatic Agents That Are Potentially Useful in Stroke Syndrome.
| Category of hemostatic agents | Examples of hemostatic agents/regimens | Potential benefit for stroke | Comments |
| Antiplatelet agents | To be used to inhibit only activation of lone ULVWF path | ||
| Oral agent | |||
| Cyclooxygenase inhibitor | ASA alone or in combination with clopidogrel; ticlopidine; dipyridamole | TIA in secondary prevention | |
| ADP receptor inhibitor | |||
| Adenosine reuptake inhibitor | |||
| Antimicrothrombotic treatments | |||
| Oral agent | N-acetyl cysteine (?) | TIA in secondary prevention (?) | |
| Parenteral therapy | rADAMTS13; TPE | Encephalopathic stroke for treatment | |
| Anti-FXa agents | To be used to inhibit only in combined activation of ULVWF and TF paths producing macrothrombus | ||
| Oral agent | |||
| Direct FXa inhibitor | Rivaroxaban; apixaban; endoxaban | AIS due to embolic stroke in secondary prevention | |
| Parenteral drug | |||
| Direct FXa inhibitor | LMWH (enoxaparin); pentasaccharides (eg, fondaprinux) | AIS in progression (?) | |
| Anti-thrombin agents | |||
| Oral agent | |||
| Direct thrombin inhibitor | Dabigatran | AIS due to embolic stroke in secondary prevention | |
| Parenteral drug | |||
| Direct thrombin inhibitor | UFH; argatroban; refludan | AIS in progression (?) | |
| Anti-fibrinogenetic agents | |||
| Oral agent | |||
| Vitamin K antagonist | Coumadin | AIS due to embolic stroke in secondary prevention | |
| Parenteral drug | |||
| Direct thrombin inhibitor | UFH | AIS in progression (?) | |
| Fibrinolytic agents | tPA (alteplase); streptokinase; urokinase | AIS for therapy | |
| Hemostatic agents | Desmopressin rFVIIa |
AHS for therapy (?) | To be used as hemostatic agent Needs clinical trials |
Abbreviations: ADP, adenosine diphosphate; AIS, acute ischemic stroke; AHA, acute hemorrhagic stroke; ASA, acetyl salicylic acid; EVT, extravascular tissue; ICH, intracerebral hemorrhage; LMWH, low-molecular-weight heparin; rADAMTS13; recombinant ADAMTS13; rATIII, recombinant antithrombin III; rFVIIa, recombinant activated factor VII; TF, tissue factor; TIA, transient ischemic attack; tPA, tissue plasminogen activator; TPE, therapeutic plasma exchange; UFH, unfractionated heparin; ULVWF, unusually large von Willebrand factor multimers.