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Controlled Trial of Ancrod in Ischemic Stroke
Volker Hossmann, MD;
Wolf-Dieter Heiss, MD;
Heiko Bewermeyer, MD;
Günter Wiedemann, MD
Arch Neurol. 1983;40(13):803-808.
Abstract
• In a randomized, single-blind study, 30 patients with acute ischemic stroke were treated with either low-molecular weight dextran and mannitol alone (group A, mean age, 63.3 ±11.8 years, n = 15) or in combination with the viper venom enzyme ancrod (group B, mean age, 67.9 ± 7.6 years, n = 15). Lowering of plasma fibrinogen levels to 100-130 mg/ dL with ancrod resulted in a significant reduction of the apparent blood viscosity, ie, of 37% at a shear rate of 0.03 s-1, compared with only 7% in group A. Fibrin degradation products increased considerably from 3.1 ± 0.4 to 154.3 ± 31.6 mg/L on day 3, while plasminogen decreased from 98.2% ± 2.0% to 79.8% ± 2.9% in group B. Global coagulation and platelet function tests were not influenced by either treatment. Neurological score improved by 1.1 arbitrary units (AU) in group A and by 2.6 AU in group B. Five patients in group A and two in group B died during the first two weeks. This preliminary study indicated a slightly better outcome in the ancrod treated patients. The beneficial effect may be due to the anticoagulative and fibrinolytic activity of ancrod rather than its effect on blood viscosity.
Author Affiliations
From the Department of Clinical Neurology, Max-Planck-Institute for Neurological Research (Drs Heiss, Bewermeyer, and Wiedemann) and the Department of Internal Medicine II (Dr Hossmann), University of Cologne, West Germany.
Footnotes
Accepted for publication Oct 28, 1982.
Reprint requests to Medizinische Universitätsklinik II, Krankenhaus Merheim, Ostmerheimerstrasse 200, 500 Köln 91, West Germany (Dr Hossmann).
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