In this episode we get together with Dr. Tess Fitzpatrick @TessFitzNeuro (first author on the recent paper on this topic: Quality of anticoagulation using intravenous unfractionated heparin for cerebrovascular indications) and Dr. Katherine Sawicka @KatherineSawic1 (our resident guru Clinical Epidemiology and lover of all things research methods) to discuss challenges with anticoagulation using unfractionated heparin. This is not to be confused with the fact that this agent provides a very good modality to providing anticoagulation and has very specific uses, but in the real world pragmatic perspective, the IV infusion of this agent causes issues with the quality of anticoagulation, and there may be better alternatives such as low molecular weight heparin (LMWH). Anticoagulating a patient with acute stroke is always a challenging topic, and there are nuances to be considered, to reduce the risk of hemorrhage, and therefore we looked back at the use of unfractionated heparin infusion in stroke and talk about how some considerations are very important to keep in mind! As usual - please note our disclaimer.