Results With Additional Use of SP 54 in Percutaneous Transluminal Angioplasty
The idea of using sulfated polyanions — such as SP 54 (Benechemie, Munich) — was prompted by several factors. First of all, it is well-known that intravascular thrombi may be dissolved by natural human fibrinolytic activity. The stimulation of this process has been widely used for a long time in the form of low-dose subcutaneous heparin therapy in major surgery. But in this case the use of heparin serves other purposes too. Depending on their molecular compounds heparin and heparin-like drugs may stimulate fibrinolytic activity . When this was investigated it was found that even old clots can be dissolved if they are not organized [2, 3]. So what would happen during and following percutaneous transluminal angioplasty (PTA) if we purposefully stimulated the fibrinolytic enzyme system? SP 54 as a sulfated polyanion has seemed a suitable substance to use in combination with PTA. Among members of the sulfated polyanion group, the capacity to activate the fibrinolytic system increases with the degree of depolymerization. Being a compound with a very low molecular weight, SP 54 shows the optimum effects; it develops no more than traces of anticoagulant activity, thus achieving adequate therapeutic mobilization and reactivation of the physiological enzyme system with negligible effects on blood coagulation . And it does not involve hypocoagulemia with the dangerous tendency to hemorrhage. The optimum single dose of SP 54 is 1–2 mg/kg. A peak in the fibrinolytic action develops after 30–60 min following intravenous administration of SP 54. With intramuscular injection the peak of fibrinolytic activation occurs 1–2 h later, decreases in the next 4–6 h and is still measurable even after 24 h. An increase in the fibrinolytic activity of about 300% can be achieved using this drug. Its other effects (lipolysis, reduction of blood viscosity, antisludging effect, antiaggregation effect, etc.) are favorable in atherosclerotic diseases.
KeywordsHeparin Prothrombin Nicotinic Acid Dicumarol Sulfated Polyanion
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