title: Ancrod: a practical alternative to heparin.
abstract: 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.
authors.affiliation: Departments of Surgery, Ottawa Civic Hospital, Ontario, Canada.
authors.forename: C W
authors.initials: CW
authors.lastname: Cole
authors.forename: J
authors.initials: J
authors.lastname: Bormanis
mesh_terms: D000328:Adult; D000368:Aged; D000721:Ancrod / Q000627:therapeutic use*; D001780:Blood Coagulation Tests; D005260:Female; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012307:Risk Factors; D013924:Thrombophlebitis / Q000188:drug therapy*; D014682:Vena Cava, Inferior
chemical_list: D006493:Heparin; D000721:Ancrod