Efficacy of iloprost (ZK36374) versus aspirin in preventing heparin-induced platelet activation during cardiac operations

Kappa, Jeffrey R.; Horn, McDonald K.; Fisher, Carol A.; Cottrell, Earl D.; Ellison, Norig; Addonizio, V. Paul

doi:10.1016/s0022-5223(19)36255-5

Cited by 31 publications

(8 citation statements)

References 28 publications

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“…Iloprost has been studied in the treatment of PAOD and conditions in which inhibition of platelet activation was assumed to be of clinical benefit. The latter included clinical trials with iloprost in cardiopulmonary bypass procedures for cardiac surgery (7,14,5 1) and hemodialysis (18,77) but the immediate clinical benefit was clearly demonstrable only in heparin-induced thrombocytopenia (42,43,80).…”

Section: Clinical Experiencementioning

confidence: 99%

Iloprost in Peripheral Vascular Disease

Krais¹,

Müller²

1991

Cardiovascular Drug Reviews

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Section: Clinical Experiencementioning

confidence: 99%

Iloprost in Peripheral Vascular Disease

Krais¹,

Müller²

1991

Cardiovascular Drug Reviews

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“…Iloprost. a stable and potent PGIz analogue, has been used to prevent platelet activation and subsequent coagulation (7). However, their uses clinically are also associated with significant Correspondence to: Dr. Stephanie J. Brister, Hamilton Civic Hospitals, Hamilton General Division; McMaster Clinic.…”

Section: Introductionmentioning

confidence: 99%

“…7th Floor. 237 Barton Street East, Hamilton, Ontario, L8L 2x2, Canada adverse side-effects: particular bleeding, and in the case of Iloprost, hypotension (6,7). Recent experimental data suggests that hirudin.…”

Section: Introductionmentioning

confidence: 99%

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Is Heparin the Ideal Anticoagulant for Cardiopulmonary Bypass? Dermatan Sulphate May Be an Alternate Choice

et al. 1994

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SummaryPerformance of cardiopulmonary bypass (CPB) during cardiac surgery requires the administration of high dose heparin to prevent CPB pump occlusion. However, this heparin use is associated with bleeding side-effects. Moreover, at the end of CPB, the heparin must be neutralized with protamine sulphate, which is also associated with adverse side-effects. A number of recent studies suggest that dermatan sulphate may be useful as an alternate anticoagulant to heparin. We determined whether CPB could be performed using dermatan sulphate instead of heparin, in an adult pig CPB model. When heparin was used, a high dose (> 200 U/kg, which generated > 3 anti-thrombin U/ml of plasma), was required to perform successful CPB and to maintain CPB pump patency. This dose was associated with a post CPB bleeding of ≈ 600 ml/2h. in contrast, successful CPB could be achieved when the pigs were given lower doses of dermatan sulphate than heparin, which in turn, were associated with less bleeding. We conclude that dermatan sulphate may be an alternate anticoagulant for cardiac surgery

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“…The purpose of this project was 2-fold: the preoperative recognition of patients with heparin-sensitive antiplatelet antibodies and the prevention of platelet activation by temporary platelet function inhibition during heparinization. Our management protocol was based on reports by Addonizio and associates, 9,10 Kappa and collaborators, 11,12 and Palatianos and colleagues (on the use of the prostacyclin analog iloprost [ZK 36374]). 13 Addonizio and associates 9,10 and Kappa and associates 11,12 reported platelet preservation with iloprost during cardiopulmonary bypass (CPB) and showed that temporary platelet inhibition with iloprost allowed safe heparin administration in patients with HITT undergoing cardiac or vascular operations.…”

mentioning

confidence: 99%