C‘riiical Rrrierr.r in zyxwvutsrqponml ONCOLOGY/ HEMA TOLOG Y Critical Reviews in Oncology/Hematology 15 (1993) 23-33 Anticoagulant therapy with ancrod R.L. Soutar, J.S. Ginsberg* McMasirr University Medical Cenrre. 1200 Muin 2. Wm. HSC-3 W15. Hamilton. Ontario LXN 325. US.4 (Accepted 19 February 1993) zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLK Contents I. Introduction 24 2. Pharmacology 3. Administration 24 4. Side effects of ancrod therapy 4.1. Bleeding 4.2. Resistance to ancrod 4.3. Other side effects 4.4 Contraindications to ancrod 5. Clinical indications . . . 5.1. 5.2 5.3 5.4 5.5 5.6. 5.7. 5.8 ......... . . Treatment of venous thromboembolism ............................................... 5.1.1. Deep venous thrombosis ...................................................... 5.1.2. Pulmonaryembolus ........................................................... Prophylaxis of venous thromboembolism ............................................. Other venous thrombotic disorders ................................................... Treatment of arterial thromboembolism ............................................... 5.4.1. Introduction ....... . ......................................................... 5.4.2. Peripheral vascular disease ..................................................... 5.4.3. Cerebrovascular disease ....................................................... 5.4.4. lschemic heart disease ......................................................... 5.4.4.1. Introduction .......................................................... 5.4.4.2. Angina pectoris ....................................................... 5.4.4.3. Myocardial infarction ............................................... .. Heparin induced thrombocytopcnia .................................................. 5.5.1. Introduction ................................................................. 5.5.2. Anticoagulation in patients with HIT ........................................... Ancrod in glomerulonephritis ....................................................... 5.6.1. Introduction ................................................................. 5.6.2. Clinical use of ancrod in patients with glomerulonephritis ......................... Ancrod as an alternative to heparin anticoagulation .................................... Other indications for ancrod ........................................................ 5.8. I Cryofibrinogenemia ........................................................... 5.8.2. Sickle cell crisis .............................................................. 5.8.3. Laboratory use of ancrod ..................................................... 5.8.4. Other reports on the clinical use of ancrod ...................................... * Corresponding author. ......... ......... ......... ,._,_..... ‘4 25 25 25 26 26 36 26 26 27 27 27 21 27 28 28 28 28 28 28 29 29 ‘9 29 29 29 30 30 30 30 30 30 lO40-8428/93/$24.00 0 1993 Elsevier Scientific Publishers Ireland Ltd. All rights reserved. SSDI 1040-8428(93)0075-Q