Analogous randomized trials have not been performed to directly evaluate 3-factor and 4-factor PCCs against each other. Additionally, the specific INR target for VKA correc- tion in OAC-related ICH is unclear, with various studies cited here and elsewhere using targets ranging from <1.3 to <1.5.88 rFVIIa, licensed to treat hemophilia patients with high titer inhibitors or congenital factor VII deficiency, has gar- nered attention as a potential treatment for spontaneous and OAC-associated ICH. Although rFVIIa can rapidly normal- ize INR in the setting of VKA-associated ICH,89 93 it does not replenish all of the vitamin K dependent factors and may not restore thrombin generation as effectively as PCCs.94 Thus, rFVIIa is not currently recommended for routine use in war- New Anticoagulant Medication Related ICH There are no randomized trials of reversing agents for newer anticoagulants among patients with ICH or other major bleed- ing complications, and because these agents have only been available for a few years, experience with reversal is limited. Currently available agents in the United States (dabigatran, rivaroxaban, and apixaban) have relatively short half-lives ranging from 5 to 15 hours. Evaluation of the activated par- tial thromboplastin time and prothrombin time and consulta- tion with a hematologist are reasonable to individualize care. Potential reversal strategies using FEIBA, other PCCs, or rFVIIa might be considered. FFP is of unclear utility, and vita- min K is not useful. It has been suggested that FEIBA or rFVIIa may be better for the direct thrombin inhibitor dabigatran, whereas other PCCs may be better for the factor Xa inhibitors rivaroxaban and apixaban,96 99 but these data are preliminary. 