COR amended to conform with ACC/AHA 2015 Recommendation Classification System. Further support for this unchanged recommendation from the 2013 AIS Guidelines is provided by 2 updated meta- analyses that confirm the lack of benefit of urgent anticoagulation.228,229 An additional study, not included in these meta-analyses, investigated the efficacy of LMWH compared with aspirin in preventing early neurological deterioration in an unblinded RCT. Although there was a statistically significant difference in early neurological deterioration at 10 days after admission (LMWH, 27 [3.95%] versus aspirin, 81 [11.82%]; P<0.001), there was no difference in 6-month See Table L in online Data Supplement 1. 3.11. Volume Expansion/Hemodilution, Vasodilators, and Hemodynamic Augmentation 3.11. Volume Expansion/Hemodilution, Vasodilators, and Hemodynamic Augmentation COR LOE New, Revised, or Unchanged Hemodilution by volume expansion is not recommended for treatment of patients with AIS. III: No Benefit A Recommendation and LOE unchanged from 2013 AIS Guidelines. COR amended to conform with ACC/AHA 2015 Recommendation Classification System. A recent Cochrane review of 4174 participants from multiple RCTs confirmed the previous guideline recommendation that hemodilution therapy, including varying methods of volume expansion with or without venesection, demonstrates no significant benefit in patients with AIS.231 See Table LII in online Data Supplement 1. The administration of high-dose albumin is not recommended for the treatment of patients with AIS. III: No Benefit A Recommendation revised from 2013 AIS Guidelines. The ALIAS (Albumin in Acute Ischemic Stroke) part II trial of high-dose albumin infusion versus placebo in patients with AIS was terminated early for futility.232 Combined analysis of the ALIAS parts I and II trials demonstrated no difference between groups in 90-day disability.233 See Table LII in online Data Supplement 1. 