Ancrod: A practical alternative to heparin

• Published in: Journal of vascular surgery Vol. 8; no. 1; pp. 59 - 63
• Main Authors: Cole, C.William, Bormanis, Janis
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01-07-1988; Elsevier
• Subjects: Adult; Aged; Ancrod - therapeutic use; Biological and medical sciences; Blood Coagulation Tests; Blood. Blood coagulation. Reticuloendothelial system; Female; Heparin - therapeutic use; Humans; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Preoperative Care; Risk Factors; Thrombophlebitis - drug therapy; Vena Cava, Inferior; Therapeutic efficiency; Human; Chemotherapy; Intravenous administration; Hemostasis; Anticoagulant; Thrombosis; Coagulopathy
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/0741-5214(88)90245-5

To rapidly start systemic anticoagulation there are few alternatives to heparin; those that may be used are often less effective and are impractical substitutes for various reasons. We report the cases of seven patients in whom anticoagulant therapy was begun with ancrod instead of heparin for one or more of the following reasons: (1) failure to achieve systemic anticoagulation in response to heparin (e.g., antithrombin III deficiency), (2) heparin-associated complications (e.g., thrombocytopenia, thrombosis, or both), and (3) combined anticoagulation and improved blood rheology considered to be potentially more beneficial than anticoagulation alone (e.g., massive thrombosis). In the cases reported, ancrod permitted systemic anticoagulation equal to that of heparin; this was achieved without bleeding complications. In contrast to streptokinase or urokinase, ancrod does not degrade preformed, fully cross-linked thrombin fibrin; consequently hemorrhagic complications are uncommon. Ancrod appears to be an appropriate alternative to heparin and may be preferable to it in certain circumstances.