Treatment of experimentally induced caval thrombosis with oral low molecular weight heparin and delivery agent in a porcine model of deep venous thrombosis.
OBJECTIVE
This experiment evaluated enterally administered low molecular weight heparin (LMWH) combined with sodium N-[10-(2-hydroxybenzoyl)amino] decanoate (SNAD) for the treatment of induced venous thrombosis.


BACKGROUND
SNAD is a delivery agent that potentiates the gastrointestinal absorption of LMWH.


METHODS
Forty female pigs were equally assigned to four groups: control (saline); enteral LMWH, 2,000 IU/kg; enteral SNAD, 50 mg/kg; and enteral LMWH, 2,000 IU/kg and SNAD, 50 mg/kg. Under fluoroscopic guidance, the infrarenal vena cava was occluded with a balloon catheter. Two milliliters of ethanol was injected into the distal vena cava. The inflated balloon catheter remained in situ for 5 days, at which time animals angiographically exhibiting thrombus were randomly assigned to the four groups. Study medications were dosed at 12-hour intervals by means of a gastrostomy tube placed previously. After 7 days of treatment, thrombus was extracted. A separate group of 10 animals was used to measure plasma antifactor Xa levels for 6 hours after enteral dosing of LMWH/SNAD.


RESULTS
The amount of residual thrombus after treatment with enteral LMWH/SNAD was significantly decreased. Antifactor Xa levels were significantly elevated in the LMWH/SNAD group versus baseline.


CONCLUSIONS
The combination of enterally administered LMWH and SNAD given for 7 days appeared to decrease caval thrombosis in this model of deep vein thrombosis. Enteral LMWH/SNAD effected an increase in plasma levels of antifactor Xa.
Salartash
K
K
Department of Surgery, Alton Ochsner Medical Foundation, Ochsner Clinic, New Orleans, Louisiana 70121, USA.
Lepore
M
M
Gonze
M D
MD
Leone-Bay
A
A
Baughman
R
R
Sternbergh
W C
WC
Bowen
J C
JC
Money
S R
SR
D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage*; D004195:Disease Models, Animal; D016503:Drug Delivery Systems; D004750:Enteral Nutrition; D005069:Evaluation Studies as Topic; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage*; D007408:Intestinal Absorption; D011897:Random Allocation; D013552:Swine; D014682:Vena Cava, Inferior; D020246:Venous Thrombosis / Q000188:drug therapy*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight