The Experts below are selected from a list of 6387 Experts worldwide ranked by ideXlab platform

Karl Werdan - One of the best experts on this subject based on the ideXlab platform.

  • Otamixaban versus UFH, enoxaparin and fondaparinux in the prevention of cardiac Catheter Thrombosis in vitro (electron microscopic results from the OPEN-CATH study)
    European Heart Journal, 2013
    Co-Authors: Anja Kaeberich, Iris Reindl, Karl Werdan, C. Cremer, C. Domenger, J. Kaiser, B. Hauroeder, Axel Schlitt
    Abstract:

    Efficient and safe anticoagulation is crucial in patients requiring percutaneous coronary intervention (PCI), where remaining rates of life-threatening complications trigger the development of new anticoagulants with improved efficacy/safety ratios. This in vitro study compared the efficacy of otamixaban, a new synthetic parenteral direct factor Xa inhibitor, with unfractionated heparin, enoxaparin and fondaparinux with/without combination with eptifibatide in the prevention of cardiac Catheter Thrombosis. Blood (49 ml each) from 10 healthy male volunteers pretreated with oral 500 mg aspirin was anticoagulated with unfractionated heparin (0.9 UI/ml), enoxaparin (0.6 IE/ml) or fondaparinux (0.5 μg/ml) at PCI-recommended doses, or with otamixaban at concentrations of 250 or 500 ng/ml. Each group was combined with/without 1.7 μg/ml eptifibatide (n=10 groups). The blood-anticoagulant mixtures were circulated continuously through a cardiac Catheter for 60 min or until the Catheter became blocked by thrombotic debris. Overall thrombus weight, global and specific coagulation parameters, and electron microscopic features such as deposits of platelets, erythrocytes and fibrin on the Catheter surface were quantified as endpoints. The otamixaban regimes differed not statistically relevant from UFH and enoxaparin groups regarding the deposition of erythrocytes and demonstrated similar or even significantly reduced platelet deposition, whereas fondaparinux treatment resulted in significant increases of both values (p

  • In vitro comparison of the novel, dual-acting FIIa/FXa-inhibitor EP217609C101, unfractionated heparin, enoxaparin, and fondaparinux in preventing cardiac Catheter Thrombosis.
    Journal of thrombosis and thrombolysis, 2013
    Co-Authors: Anja Kaeberich, Michael Buerke, Baerbel Hauroeder, Uwe Raaz, Alexander Vogt, Lars Maedgefessel, E Neuhart, C Krezel, Ludovic Drouget, Karl Werdan
    Abstract:

    Efficient and safe anticoagulation is crucial in patients requiring percutaneous coronary intervention (PCI) or extracorporeal circulation during cardiac surgery. Although new anticoagulant strategies have emerged for PCI as alternatives to the established treatment with heparins, the development of new anticoagulants with an improved efficacy/safety ratio is still necessary. Our study compared the efficacy of the novel, dual-acting, neutralizable FIIa/FXa-inhibitor EP217609C101 (EP) at 2, 1.2, 0.9, and 0.6 μg/ml to unfractionated heparin (UFH), enoxaparin, and fondaparinux in preventing cardiac Catheter Thrombosis under in vitro conditions. Blood drawn by venepunction from healthy male volunteers (n = 10) pretreated with 500 mg aspirin orally was treated with the anticoagulant to test and continuously circulated through a cardiac Catheter for 60 min or until the Catheter became blocked by thrombotic debris. Anticoagulant efficacy was assessed by thrombus weight, electron microscopic features of the developing thrombi, and laboratory parameters. Whereas UFH, enoxaparin, EP 2, and EP 1.2 μg/ml secured maximum circulation times, statistically significant premature Catheter occlusions were observed for EP 0.9, EP 0.6 μg/ml, and fondaparinux. The UFH group and both high-dose concentrations of EP showed significantly lower thrombus weights than the low-dose concentrations of EP and fondaparinux, (p ≤ 0.05). On electron microscopic analysis of the thrombotic debris no differences were observed in erythrocyte deposition between UFH, enoxaparin, and all EP concentrations tested. A significant reduction in fibrin deposition was achieved by UFH and EP 2 μg/ml but no significant differences in platelet deposition were found, except for a significant reduction for EP 0.6 μg/ml. Our in vitro study showed that EP217609C101 is a promising new drug that is dose-dependently superior to classical (UFH, enoxaparin) and newer (fondaparinux) drugs in preventing heart Catheter Thrombosis.

  • Efficacy of enoxaparin, certoparin and dalteparin in preventing cardiac Catheter Thrombosis: an in vitro approach
    Journal of Thrombosis and Thrombolysis, 2010
    Co-Authors: Uwe Raaz, Michael Buerke, Baerbel Hauroeder, Karl Werdan, Lars Maegdefessel, Marese Busshardt, Alexander Plehn, Axel Schlitt
    Abstract:

    Owing to its beneficial pharmacological profile, the low-molecular-weight heparin (LMWH) enoxaparin is increasingly being taken as an alternative to UFH in the treatment of ACS with an early invasive strategy and in elective percutaneous coronary interventions (PCI). Insufficient anticoagulation increases the risk of Catheter thrombus formation during PCI. The aim of the present study was to test in vitro the hypotheses that (i) inhibiting thrombin or thrombin generation by administering LMWH is a critical intervention in preventing Catheter thrombus formation and (ii) other LMWH such as certoparin or dalteparin are as effective as enoxaparin. Blood pre-treated with the anticoagulants of interest was continuously circulated through a guiding Catheter by using a roller pump for a maximum experimental period of 60 min or until the Catheter became occluded. Overall thrombus weight, anti-Xa activity and electron microscopic features such as deposits of platelets, erythrocytes and fibrin on the Catheter surface were quantified as endpoints. All LMWH tested significantly reduced Catheter thrombus generation comparable to UFH treatment whereas there was no difference between the specific LMWH with respect to Catheter thrombus formation or deposition of platelets, erythrocytes and fibrin. Thrombus generation was found to negatively correlate with anti-Xa activity. The additional use of eptifibatide did not affect thrombus formation. These data suggest that modulating plasmatic coagulation by employing LMWH is critical for preventing Catheter thrombus formation and at the same time offer a potential for administering LMWH other than enoxaparin, such as certoparin or dalteparin, in the setting of PCI.

  • The direct thrombin inhibitor argatroban effectively prevents cardiac Catheter Thrombosis in vitro
    Thrombosis and haemostasis, 2010
    Co-Authors: Uwe Raaz, Michael Buerke, Sebastian Schubert, Lars Maegdefessel, Marese Busshardt, Alexander Plehn, Anja Kaeberich, Martin Russ, Henning Ebelt, Karl Werdan
    Abstract:

    The direct thrombin inhibitor argatroban offers some significant advantages over unfractionated heparin (UFH) and is recommended as an alternative anticoagulant during percutaneous coronary interventions (PCI). The impact of argatroban on cardiac Catheter Thrombosis – a severe potential complication of PCI – has not been systematically studied yet. The aim of the present study was to test in vitro the hypothesis that argatroban is equivalent to the more established anticoagulants UFH and enoxaparin in preventing Catheter thrombus formation. Blood pretreated with the anticoagulants of interest was continuously circulated through a guiding Catheter by using a roller pump for a maximum experimental period of 60 minutes. In an alternate model, coagulation was mechanically induced by a magnetic stirrer. Coagulation parameters, overall thrombus weight and electron microscopic features (deposits of platelets and fibrin on the Catheter surface) were quantified as endpoints. Argatroban (administered as bolus or continuous infusion), UFH (bolus), and enoxaparin (bolus) significantly reduced Catheter thrombus formation compared to untreated controls. Here, neither overall thrombus weight nor platelet/fibrin deposition was different among the specific anticoagulants. Declining ACT (activated clotting time) levels – which were found in the argatroban bolus group – could be prevented by continuous infusion. In magnetic stirrer-induced coagulation, thrombus weight was lower following bolus treatment with UFH and enoxaparin compared to argatroban. These data suggest that the potential for argatroban in preventing Catheter Thrombosis is comparable to that of UFH and enoxaparin. However, the anticoagulatory efficacy varied, depending on the model of coagulation activation, which demonstrates the necessity for specific testing.

  • Comparison of bivalirudin, enoxaparin, and unfractionated heparin in preventing cardiac Catheter Thrombosis
    Thrombosis and Haemostasis, 2008
    Co-Authors: Michael Buerke, Sebastian Schubert, Iris Reindl, Thomas Michel, Baerbel Hauroeder, Justin M. Carter, Dirk Peetz, Karl Werdan, Axel Schlitt, Lars Maegdefessel
    Abstract:

    SummaryBivalirudin, a direct thrombin inhibitor binds specifically and reversibly to both fibrin-bound and unbound thrombin. Bivalirudin is approved for use as an anticoagulant in patients undergoing percutaneous coronary intervention. The OASIS-5 trial presented a significant increase in cardiac Catheter Thrombosis for the pentasaccharid fondaparinux compared to enoxaparin. Catheter Thrombosis has never been reported in any trial using bivalirudin. Our study compared the development of Catheter Thrombosis for bivalirudin, enoxaparin, and unfractionated heparin in a controlled in-vitro environment. Ten healthy male volunteers were pretreated with aspirin 500 mg 2 hours before venesection of 50 ml of blood. The seven groups of anticoagulant combinations tested were:UFH, UFH + eptifibatide, enoxaparin, enoxaparin + eptifibatide, bivalirudin bolus, bivalirudin + eptifibatide, bivalirudin bolus + continuous infusion. The blood/anticoagulant mix continuously circulated through a cardiac guiding Catheter for 60 minutes or until the Catheter became blocked with thrombus. Thrombus development was assessed by weighing each Catheter before and after the procedure. Electron microscopy was used to quantify the degree of erythrocyte, platelet and fibrin deposition. Following anticoagulation with bolus dose bivalirudin, the Catheter was invariably occluded with thrombus after 33 minutes of circulation. However, a continuous infusion of Bivalirudin prevented the development of occlusive Catheter Thrombosis. In the bolus bivalirudin group the mean thrombus weight was significantly greater than in all other groups (p-value < 0.01 in all analyses). Bivalirudin given as a bolus was not sufficient to prevent cardiac Catheter Thrombosis in our in-vitro study. However, a continuous infusion of bivalirudin had similar anti-thrombotic efficacy compared to other treatment strategies.

Michael Buerke - One of the best experts on this subject based on the ideXlab platform.

  • in vitro comparison of the novel dual acting fiia fxa inhibitor ep217609c101 unfractionated heparin enoxaparin and fondaparinux in preventing cardiac Catheter Thrombosis
    Journal of Thrombosis and Thrombolysis, 2014
    Co-Authors: Anja Kaeberich, Baerbel Hauroeder, Uwe Raaz, Alexander Vogt, Lars Maedgefessel, E Neuhart, C Krezel, Ludovic Drouget, Michael Buerke
    Abstract:

    Efficient and safe anticoagulation is crucial in patients requiring percutaneous coronary intervention (PCI) or extracorporeal circulation during cardiac surgery. Although new anticoagulant strategies have emerged for PCI as alternatives to the established treatment with heparins, the development of new anticoagulants with an improved efficacy/safety ratio is still necessary. Our study compared the efficacy of the novel, dual-acting, neutralizable FIIa/FXa-inhibitor EP217609C101 (EP) at 2, 1.2, 0.9, and 0.6 μg/ml to unfractionated heparin (UFH), enoxaparin, and fondaparinux in preventing cardiac Catheter Thrombosis under in vitro conditions. Blood drawn by venepunction from healthy male volunteers (n = 10) pretreated with 500 mg aspirin orally was treated with the anticoagulant to test and continuously circulated through a cardiac Catheter for 60 min or until the Catheter became blocked by thrombotic debris. Anticoagulant efficacy was assessed by thrombus weight, electron microscopic features of the developing thrombi, and laboratory parameters. Whereas UFH, enoxaparin, EP 2, and EP 1.2 μg/ml secured maximum circulation times, statistically significant premature Catheter occlusions were observed for EP 0.9, EP 0.6 μg/ml, and fondaparinux. The UFH group and both high-dose concentrations of EP showed significantly lower thrombus weights than the low-dose concentrations of EP and fondaparinux, (p ≤ 0.05). On electron microscopic analysis of the thrombotic debris no differences were observed in erythrocyte deposition between UFH, enoxaparin, and all EP concentrations tested. A significant reduction in fibrin deposition was achieved by UFH and EP 2 μg/ml but no significant differences in platelet deposition were found, except for a significant reduction for EP 0.6 μg/ml. Our in vitro study showed that EP217609C101 is a promising new drug that is dose-dependently superior to classical (UFH, enoxaparin) and newer (fondaparinux) drugs in preventing heart Catheter Thrombosis.

  • In vitro comparison of the novel, dual-acting FIIa/FXa-inhibitor EP217609C101, unfractionated heparin, enoxaparin, and fondaparinux in preventing cardiac Catheter Thrombosis.
    Journal of thrombosis and thrombolysis, 2013
    Co-Authors: Anja Kaeberich, Michael Buerke, Baerbel Hauroeder, Uwe Raaz, Alexander Vogt, Lars Maedgefessel, E Neuhart, C Krezel, Ludovic Drouget, Karl Werdan
    Abstract:

    Efficient and safe anticoagulation is crucial in patients requiring percutaneous coronary intervention (PCI) or extracorporeal circulation during cardiac surgery. Although new anticoagulant strategies have emerged for PCI as alternatives to the established treatment with heparins, the development of new anticoagulants with an improved efficacy/safety ratio is still necessary. Our study compared the efficacy of the novel, dual-acting, neutralizable FIIa/FXa-inhibitor EP217609C101 (EP) at 2, 1.2, 0.9, and 0.6 μg/ml to unfractionated heparin (UFH), enoxaparin, and fondaparinux in preventing cardiac Catheter Thrombosis under in vitro conditions. Blood drawn by venepunction from healthy male volunteers (n = 10) pretreated with 500 mg aspirin orally was treated with the anticoagulant to test and continuously circulated through a cardiac Catheter for 60 min or until the Catheter became blocked by thrombotic debris. Anticoagulant efficacy was assessed by thrombus weight, electron microscopic features of the developing thrombi, and laboratory parameters. Whereas UFH, enoxaparin, EP 2, and EP 1.2 μg/ml secured maximum circulation times, statistically significant premature Catheter occlusions were observed for EP 0.9, EP 0.6 μg/ml, and fondaparinux. The UFH group and both high-dose concentrations of EP showed significantly lower thrombus weights than the low-dose concentrations of EP and fondaparinux, (p ≤ 0.05). On electron microscopic analysis of the thrombotic debris no differences were observed in erythrocyte deposition between UFH, enoxaparin, and all EP concentrations tested. A significant reduction in fibrin deposition was achieved by UFH and EP 2 μg/ml but no significant differences in platelet deposition were found, except for a significant reduction for EP 0.6 μg/ml. Our in vitro study showed that EP217609C101 is a promising new drug that is dose-dependently superior to classical (UFH, enoxaparin) and newer (fondaparinux) drugs in preventing heart Catheter Thrombosis.

  • Efficacy of enoxaparin, certoparin and dalteparin in preventing cardiac Catheter Thrombosis: an in vitro approach
    Journal of Thrombosis and Thrombolysis, 2010
    Co-Authors: Uwe Raaz, Michael Buerke, Baerbel Hauroeder, Karl Werdan, Lars Maegdefessel, Marese Busshardt, Alexander Plehn, Axel Schlitt
    Abstract:

    Owing to its beneficial pharmacological profile, the low-molecular-weight heparin (LMWH) enoxaparin is increasingly being taken as an alternative to UFH in the treatment of ACS with an early invasive strategy and in elective percutaneous coronary interventions (PCI). Insufficient anticoagulation increases the risk of Catheter thrombus formation during PCI. The aim of the present study was to test in vitro the hypotheses that (i) inhibiting thrombin or thrombin generation by administering LMWH is a critical intervention in preventing Catheter thrombus formation and (ii) other LMWH such as certoparin or dalteparin are as effective as enoxaparin. Blood pre-treated with the anticoagulants of interest was continuously circulated through a guiding Catheter by using a roller pump for a maximum experimental period of 60 min or until the Catheter became occluded. Overall thrombus weight, anti-Xa activity and electron microscopic features such as deposits of platelets, erythrocytes and fibrin on the Catheter surface were quantified as endpoints. All LMWH tested significantly reduced Catheter thrombus generation comparable to UFH treatment whereas there was no difference between the specific LMWH with respect to Catheter thrombus formation or deposition of platelets, erythrocytes and fibrin. Thrombus generation was found to negatively correlate with anti-Xa activity. The additional use of eptifibatide did not affect thrombus formation. These data suggest that modulating plasmatic coagulation by employing LMWH is critical for preventing Catheter thrombus formation and at the same time offer a potential for administering LMWH other than enoxaparin, such as certoparin or dalteparin, in the setting of PCI.

  • The direct thrombin inhibitor argatroban effectively prevents cardiac Catheter Thrombosis in vitro
    Thrombosis and haemostasis, 2010
    Co-Authors: Uwe Raaz, Michael Buerke, Sebastian Schubert, Lars Maegdefessel, Marese Busshardt, Alexander Plehn, Anja Kaeberich, Martin Russ, Henning Ebelt, Karl Werdan
    Abstract:

    The direct thrombin inhibitor argatroban offers some significant advantages over unfractionated heparin (UFH) and is recommended as an alternative anticoagulant during percutaneous coronary interventions (PCI). The impact of argatroban on cardiac Catheter Thrombosis – a severe potential complication of PCI – has not been systematically studied yet. The aim of the present study was to test in vitro the hypothesis that argatroban is equivalent to the more established anticoagulants UFH and enoxaparin in preventing Catheter thrombus formation. Blood pretreated with the anticoagulants of interest was continuously circulated through a guiding Catheter by using a roller pump for a maximum experimental period of 60 minutes. In an alternate model, coagulation was mechanically induced by a magnetic stirrer. Coagulation parameters, overall thrombus weight and electron microscopic features (deposits of platelets and fibrin on the Catheter surface) were quantified as endpoints. Argatroban (administered as bolus or continuous infusion), UFH (bolus), and enoxaparin (bolus) significantly reduced Catheter thrombus formation compared to untreated controls. Here, neither overall thrombus weight nor platelet/fibrin deposition was different among the specific anticoagulants. Declining ACT (activated clotting time) levels – which were found in the argatroban bolus group – could be prevented by continuous infusion. In magnetic stirrer-induced coagulation, thrombus weight was lower following bolus treatment with UFH and enoxaparin compared to argatroban. These data suggest that the potential for argatroban in preventing Catheter Thrombosis is comparable to that of UFH and enoxaparin. However, the anticoagulatory efficacy varied, depending on the model of coagulation activation, which demonstrates the necessity for specific testing.

  • Comparison of bivalirudin, enoxaparin, and unfractionated heparin in preventing cardiac Catheter Thrombosis
    Thrombosis and Haemostasis, 2008
    Co-Authors: Michael Buerke, Sebastian Schubert, Iris Reindl, Thomas Michel, Baerbel Hauroeder, Justin M. Carter, Dirk Peetz, Karl Werdan, Axel Schlitt, Lars Maegdefessel
    Abstract:

    SummaryBivalirudin, a direct thrombin inhibitor binds specifically and reversibly to both fibrin-bound and unbound thrombin. Bivalirudin is approved for use as an anticoagulant in patients undergoing percutaneous coronary intervention. The OASIS-5 trial presented a significant increase in cardiac Catheter Thrombosis for the pentasaccharid fondaparinux compared to enoxaparin. Catheter Thrombosis has never been reported in any trial using bivalirudin. Our study compared the development of Catheter Thrombosis for bivalirudin, enoxaparin, and unfractionated heparin in a controlled in-vitro environment. Ten healthy male volunteers were pretreated with aspirin 500 mg 2 hours before venesection of 50 ml of blood. The seven groups of anticoagulant combinations tested were:UFH, UFH + eptifibatide, enoxaparin, enoxaparin + eptifibatide, bivalirudin bolus, bivalirudin + eptifibatide, bivalirudin bolus + continuous infusion. The blood/anticoagulant mix continuously circulated through a cardiac guiding Catheter for 60 minutes or until the Catheter became blocked with thrombus. Thrombus development was assessed by weighing each Catheter before and after the procedure. Electron microscopy was used to quantify the degree of erythrocyte, platelet and fibrin deposition. Following anticoagulation with bolus dose bivalirudin, the Catheter was invariably occluded with thrombus after 33 minutes of circulation. However, a continuous infusion of Bivalirudin prevented the development of occlusive Catheter Thrombosis. In the bolus bivalirudin group the mean thrombus weight was significantly greater than in all other groups (p-value < 0.01 in all analyses). Bivalirudin given as a bolus was not sufficient to prevent cardiac Catheter Thrombosis in our in-vitro study. However, a continuous infusion of bivalirudin had similar anti-thrombotic efficacy compared to other treatment strategies.

Axel Schlitt - One of the best experts on this subject based on the ideXlab platform.

  • Otamixaban versus UFH, enoxaparin and fondaparinux in the prevention of cardiac Catheter Thrombosis in vitro (electron microscopic results from the OPEN-CATH study)
    European Heart Journal, 2013
    Co-Authors: Anja Kaeberich, Iris Reindl, Karl Werdan, C. Cremer, C. Domenger, J. Kaiser, B. Hauroeder, Axel Schlitt
    Abstract:

    Efficient and safe anticoagulation is crucial in patients requiring percutaneous coronary intervention (PCI), where remaining rates of life-threatening complications trigger the development of new anticoagulants with improved efficacy/safety ratios. This in vitro study compared the efficacy of otamixaban, a new synthetic parenteral direct factor Xa inhibitor, with unfractionated heparin, enoxaparin and fondaparinux with/without combination with eptifibatide in the prevention of cardiac Catheter Thrombosis. Blood (49 ml each) from 10 healthy male volunteers pretreated with oral 500 mg aspirin was anticoagulated with unfractionated heparin (0.9 UI/ml), enoxaparin (0.6 IE/ml) or fondaparinux (0.5 μg/ml) at PCI-recommended doses, or with otamixaban at concentrations of 250 or 500 ng/ml. Each group was combined with/without 1.7 μg/ml eptifibatide (n=10 groups). The blood-anticoagulant mixtures were circulated continuously through a cardiac Catheter for 60 min or until the Catheter became blocked by thrombotic debris. Overall thrombus weight, global and specific coagulation parameters, and electron microscopic features such as deposits of platelets, erythrocytes and fibrin on the Catheter surface were quantified as endpoints. The otamixaban regimes differed not statistically relevant from UFH and enoxaparin groups regarding the deposition of erythrocytes and demonstrated similar or even significantly reduced platelet deposition, whereas fondaparinux treatment resulted in significant increases of both values (p

  • Efficacy of enoxaparin, certoparin and dalteparin in preventing cardiac Catheter Thrombosis: an in vitro approach
    Journal of Thrombosis and Thrombolysis, 2010
    Co-Authors: Uwe Raaz, Michael Buerke, Baerbel Hauroeder, Karl Werdan, Lars Maegdefessel, Marese Busshardt, Alexander Plehn, Axel Schlitt
    Abstract:

    Owing to its beneficial pharmacological profile, the low-molecular-weight heparin (LMWH) enoxaparin is increasingly being taken as an alternative to UFH in the treatment of ACS with an early invasive strategy and in elective percutaneous coronary interventions (PCI). Insufficient anticoagulation increases the risk of Catheter thrombus formation during PCI. The aim of the present study was to test in vitro the hypotheses that (i) inhibiting thrombin or thrombin generation by administering LMWH is a critical intervention in preventing Catheter thrombus formation and (ii) other LMWH such as certoparin or dalteparin are as effective as enoxaparin. Blood pre-treated with the anticoagulants of interest was continuously circulated through a guiding Catheter by using a roller pump for a maximum experimental period of 60 min or until the Catheter became occluded. Overall thrombus weight, anti-Xa activity and electron microscopic features such as deposits of platelets, erythrocytes and fibrin on the Catheter surface were quantified as endpoints. All LMWH tested significantly reduced Catheter thrombus generation comparable to UFH treatment whereas there was no difference between the specific LMWH with respect to Catheter thrombus formation or deposition of platelets, erythrocytes and fibrin. Thrombus generation was found to negatively correlate with anti-Xa activity. The additional use of eptifibatide did not affect thrombus formation. These data suggest that modulating plasmatic coagulation by employing LMWH is critical for preventing Catheter thrombus formation and at the same time offer a potential for administering LMWH other than enoxaparin, such as certoparin or dalteparin, in the setting of PCI.

  • Comparison of bivalirudin, enoxaparin, and unfractionated heparin in preventing cardiac Catheter Thrombosis
    Thrombosis and Haemostasis, 2008
    Co-Authors: Michael Buerke, Sebastian Schubert, Iris Reindl, Thomas Michel, Baerbel Hauroeder, Justin M. Carter, Dirk Peetz, Karl Werdan, Axel Schlitt, Lars Maegdefessel
    Abstract:

    SummaryBivalirudin, a direct thrombin inhibitor binds specifically and reversibly to both fibrin-bound and unbound thrombin. Bivalirudin is approved for use as an anticoagulant in patients undergoing percutaneous coronary intervention. The OASIS-5 trial presented a significant increase in cardiac Catheter Thrombosis for the pentasaccharid fondaparinux compared to enoxaparin. Catheter Thrombosis has never been reported in any trial using bivalirudin. Our study compared the development of Catheter Thrombosis for bivalirudin, enoxaparin, and unfractionated heparin in a controlled in-vitro environment. Ten healthy male volunteers were pretreated with aspirin 500 mg 2 hours before venesection of 50 ml of blood. The seven groups of anticoagulant combinations tested were:UFH, UFH + eptifibatide, enoxaparin, enoxaparin + eptifibatide, bivalirudin bolus, bivalirudin + eptifibatide, bivalirudin bolus + continuous infusion. The blood/anticoagulant mix continuously circulated through a cardiac guiding Catheter for 60 minutes or until the Catheter became blocked with thrombus. Thrombus development was assessed by weighing each Catheter before and after the procedure. Electron microscopy was used to quantify the degree of erythrocyte, platelet and fibrin deposition. Following anticoagulation with bolus dose bivalirudin, the Catheter was invariably occluded with thrombus after 33 minutes of circulation. However, a continuous infusion of Bivalirudin prevented the development of occlusive Catheter Thrombosis. In the bolus bivalirudin group the mean thrombus weight was significantly greater than in all other groups (p-value < 0.01 in all analyses). Bivalirudin given as a bolus was not sufficient to prevent cardiac Catheter Thrombosis in our in-vitro study. However, a continuous infusion of bivalirudin had similar anti-thrombotic efficacy compared to other treatment strategies.

  • Comparison of bivalirudin, enoxaparin, and unfractionated heparin in preventing cardiac Catheter Thrombosis - Results of an in-vitro study
    Thrombosis and haemostasis, 2008
    Co-Authors: Lars Maegdefessel, Michael Buerke, Sebastian Schubert, Iris Reindl, Thomas Michel, Baerbel Hauroeder, Justin M. Carter, Dirk Peetz, Karl Werdan, Axel Schlitt
    Abstract:

    Bivalirudin, a direct thrombin inhibitor binds specifically and reversibly to both fibrin-bound and unbound thrombin. Bivalirudin is approved for use as an anticoagulant in patients undergoing percutaneous coronary intervention. The OASIS-5 trial presented a significant increase in cardiac Catheter Thrombosis for the pentasaccharid fondaparinux compared to enoxaparin. Catheter Thrombosis has never been reported in any trial using bivalirudin. Our study compared the development of Catheter Thrombosis for bivalirudin,enoxaparin,and unfractionated heparin in a controlled in-vitro environment.Ten healthy male volunteers were pretreated with aspirin 500 mg 2 hours before venesection of 50 ml of blood. The seven groups of anticoagulant combinations tested were: UFH, UFH + eptifibatide, enoxaparin, enoxaparin + eptifibatide, bivalirudin bolus, bivalirudin + eptifibatide, bivalirudin bolus + continuous infusion.The blood/anticoagulant mix continuously circulated through a cardiac guiding Catheter for 60 minutes or until the Catheter became blocked with thrombus.Thrombus development was assessed by weighing each Catheter before and after the procedure. Electron microscopy was used to quantify the degree of erythrocyte, platelet and fibrin deposition. Following anticoagulation with bolus dose bivalirudin, the Catheter was invariably occluded with thrombus after 33 minutes of circulation.However,a continuous infusion of Bivalirudin prevented the development of occlusive Catheter Thrombosis. In the bolus bivalirudin group the mean thrombus weight was significantly greater than in all other groups (p-value < 0.01 in all analyses).Bivalirudin given as a bolus was not sufficient to prevent cardiac Catheter Thrombosis in our in-vitro study. However, a continuous infusion of bivalirudin had similar anti-thrombotic efficacy compared to other treatment strategies.

Francis Cajfinger - One of the best experts on this subject based on the ideXlab platform.

  • [Recommendations for venous thromboembolic events treatment and central venous Catheter Thrombosis management in cancer patients]
    La Presse Médicale, 2009
    Co-Authors: Antoine Elias, Philippe Debourdeau, Jean Marc Renaudin, Hélène Desmurs-clavel, Isabelle Mahé, Ismail Elalamy, Michel Pavic, Diana Kassab-chahmi, Lise Bosquet, Francis Cajfinger
    Abstract:

    The "Standards, Options: Recommendations" (SOR) project has been undertaken by the French National Federation of Cancer Centers (FNCLCC) and is now part of the French National Cancer Institute. The project involves the development and updating of evidence-based Clinical Practice Guidelines (CPG) in oncology. In order to answer questions related to venous thromboembolic events (VTE) treatment and to central venous Catheter Thrombosis (CVCT) management in cancer patients, the SOR elaborated national guidelines, here presented in a short report. It results of a collaborative work with members from three learned societies (> : SNFMI, > : SFMV and

  • Traitement curatif de la maladie thromboembolique veineuse et prise en charge des thromboses veineuses sur cathéter chez les patients atteints de cancer: Méthode SOR
    Presse medicale (Paris France : 1983), 2009
    Co-Authors: Antoine Elias, Philippe Debourdeau, Jean Marc Renaudin, Hélène Desmurs-clavel, Isabelle Mahé, Ismail Elalamy, Michel Pavic, Diana Kassab-chahmi, Lise Bosquet, Francis Cajfinger
    Abstract:

    The "Standards, Options: Recommendations" (SOR) project has been undertaken by the French National Federation of Cancer Centers (FNCLCC) and is now part of the French National Cancer Institute. The project involves the development and updating of evidence-based Clinical Practice Guidelines (CPG) in oncology. In order to answer questions related to venous thromboembolic events (VTE) treatment and to central venous Catheter Thrombosis (CVCT) management in cancer patients, the SOR elaborated national guidelines, here presented in a short report. It results of a collaborative work with members from three learned societies ( > : SNFMI, > : SFMV and > : SFAR).

  • [2008 Standards, Options: recommendations for venous thromboembolic events (VTE) treatment and central venous Catheter Thrombosis (CVCT) management in cancer patients]
    Bulletin du Cancer, 2008
    Co-Authors: Philippe Debourdeau, Antoine Elias, Hélène Desmurs-clavel, Diana Kassab-chahmi, Lise Bosquet, Francis Cajfinger, D Farge-bancel, Eric Desruennes, Marie-cécile Douard, Ismail Elalamy
    Abstract:

    The (SOR) project has been undertaken by the French National Federation of Cancer Centers (FNCLCC) is now part of the French National Cancer Institute. The project involves the development and updating of evidence-based Clinical Practice Guidelines (CPG) in oncology. In order to answer questions related to venous thromboembolic events (VTE) treatment and to central venous Catheter Thrombosis (CVCT) management in cancer patients, the SOR elaborated national guidelines, here presented in a short report. It results of a collaborative work with members from three learned societies ("société nationale française de médicine interne": SNFMI, "société française de médicine vasculaire": SFMV and "société française d'anesthésie-réanimation": SFAR).

  • 2008 Standards, Options: Recommendations for venous thromboembolic events(VTE)treatment and central venous Catheter Thrombosis(CVCT) management in cancer patients
    Journal des maladies vasculaires, 2008
    Co-Authors: Isabelle Mahé, Ismail Elalamy, Diana Kassab-chahmi, Lise Bosquet, D Farge-bancel, Patrick Mismetti, M. L. Scrobohaci, Hamid Hocini, G. Meyer, Francis Cajfinger
    Abstract:

    The Standards, Options: Recommendations (SOR) project has been undertaken by the French National Federation of Cancer Centers (FNCLCC) is now part of the French National Cancer Institute. The project involves the development and updating of evidence-based Clinical Practice Guidelines (CPG) in oncology. In order to answer questions related to venous thromboembolic events(VTE) treatment and to central venous Catheter Thrombosis (CVCT) management in cancer patients, the SOR elaborated national guidelines, here presented in a short report. It results of a collaborative work with members from three learned societies("societe nationale francaise de medicine interne": SNFMI, "societe francaise de medicine vasculaire": SFMV and "societe francaise dEanesthesie-reanimation:SFAR).

  • 2008 Standards, Options: recommendations for venous thromboembolic events (VTE) treatment and central venous Catheter Thrombosis (CVCT) management in cancer patients
    Bulletin du cancer, 2008
    Co-Authors: Philippe Debourdeau, Antoine Elias, Hélène Desmurs-clavel, Diana Kassab-chahmi, Lise Bosquet, Francis Cajfinger, D Farge-bancel, Eric Desruennes, Marie-cécile Douard, Ismail Elalamy
    Abstract:

    The (SOR) project has been undertaken by the French National Federation of Cancer Centers (FNCLCC) is now part of the French National Cancer Institute. The project involves the development and updating of evidence-based Clinical Practice Guidelines (CPG) in oncology. In order to answer questions related to venous thromboembolic events (VTE) treatment and to central venous Catheter Thrombosis (CVCT) management in cancer patients, the SOR elaborated national guidelines, here presented in a short report. It results of a collaborative work with members from three learned societies ("societe nationale francaise de medicine interne": SNFMI, "societe francaise de medicine vasculaire": SFMV and "societe francaise d'anesthesie-reanimation": SFAR).

Ismail Elalamy - One of the best experts on this subject based on the ideXlab platform.

  • [Recommendations for venous thromboembolic events treatment and central venous Catheter Thrombosis management in cancer patients]
    La Presse Médicale, 2009
    Co-Authors: Antoine Elias, Philippe Debourdeau, Jean Marc Renaudin, Hélène Desmurs-clavel, Isabelle Mahé, Ismail Elalamy, Michel Pavic, Diana Kassab-chahmi, Lise Bosquet, Francis Cajfinger
    Abstract:

    The "Standards, Options: Recommendations" (SOR) project has been undertaken by the French National Federation of Cancer Centers (FNCLCC) and is now part of the French National Cancer Institute. The project involves the development and updating of evidence-based Clinical Practice Guidelines (CPG) in oncology. In order to answer questions related to venous thromboembolic events (VTE) treatment and to central venous Catheter Thrombosis (CVCT) management in cancer patients, the SOR elaborated national guidelines, here presented in a short report. It results of a collaborative work with members from three learned societies (> : SNFMI, > : SFMV and

  • Traitement curatif de la maladie thromboembolique veineuse et prise en charge des thromboses veineuses sur cathéter chez les patients atteints de cancer: Méthode SOR
    Presse medicale (Paris France : 1983), 2009
    Co-Authors: Antoine Elias, Philippe Debourdeau, Jean Marc Renaudin, Hélène Desmurs-clavel, Isabelle Mahé, Ismail Elalamy, Michel Pavic, Diana Kassab-chahmi, Lise Bosquet, Francis Cajfinger
    Abstract:

    The "Standards, Options: Recommendations" (SOR) project has been undertaken by the French National Federation of Cancer Centers (FNCLCC) and is now part of the French National Cancer Institute. The project involves the development and updating of evidence-based Clinical Practice Guidelines (CPG) in oncology. In order to answer questions related to venous thromboembolic events (VTE) treatment and to central venous Catheter Thrombosis (CVCT) management in cancer patients, the SOR elaborated national guidelines, here presented in a short report. It results of a collaborative work with members from three learned societies ( > : SNFMI, > : SFMV and > : SFAR).

  • [2008 Standards, Options: Recommendations for venous thromboembolic events(VTE)treatment and central venous Catheter Thrombosis(CVCT) management in cancer patients]
    Journal des Maladies Vasculaires, 2008
    Co-Authors: Non Renseigné, Isabelle Mahé, Ismail Elalamy, Diana Kassab-chahmi, D Farge-bancel, Patrick Mismetti, M. L. Scrobohaci, Hamid Hocini, G. Meyer, Lise Bosquet
    Abstract:

    The Standards, Options: Recommendations (SOR) project has been undertaken by the French National Federation of Cancer Centers (FNCLCC) is now part of the French National Cancer Institute. The project involves the development and updating of evidence-based Clinical Practice Guidelines (CPG) in oncology. In order to answer questions related to venous thromboembolic events(VTE) treatment and to central venous Catheter Thrombosis (CVCT) management in cancer patients, the SOR elaborated national guidelines, here presented in a short report. It results of a collaborative work with members from three learned societies("société nationale française de médicine interne": SNFMI, "société française de médicine vasculaire": SFMV and "société française dEanesthésie-réanimation:SFAR).

  • [2008 Standards, Options: recommendations for venous thromboembolic events (VTE) treatment and central venous Catheter Thrombosis (CVCT) management in cancer patients]
    Bulletin du Cancer, 2008
    Co-Authors: Philippe Debourdeau, Antoine Elias, Hélène Desmurs-clavel, Diana Kassab-chahmi, Lise Bosquet, Francis Cajfinger, D Farge-bancel, Eric Desruennes, Marie-cécile Douard, Ismail Elalamy
    Abstract:

    The (SOR) project has been undertaken by the French National Federation of Cancer Centers (FNCLCC) is now part of the French National Cancer Institute. The project involves the development and updating of evidence-based Clinical Practice Guidelines (CPG) in oncology. In order to answer questions related to venous thromboembolic events (VTE) treatment and to central venous Catheter Thrombosis (CVCT) management in cancer patients, the SOR elaborated national guidelines, here presented in a short report. It results of a collaborative work with members from three learned societies ("société nationale française de médicine interne": SNFMI, "société française de médicine vasculaire": SFMV and "société française d'anesthésie-réanimation": SFAR).

  • 2008 Standards, Options: Recommendations for venous thromboembolic events(VTE)treatment and central venous Catheter Thrombosis(CVCT) management in cancer patients
    Journal des maladies vasculaires, 2008
    Co-Authors: Isabelle Mahé, Ismail Elalamy, Diana Kassab-chahmi, Lise Bosquet, D Farge-bancel, Patrick Mismetti, M. L. Scrobohaci, Hamid Hocini, G. Meyer, Francis Cajfinger
    Abstract:

    The Standards, Options: Recommendations (SOR) project has been undertaken by the French National Federation of Cancer Centers (FNCLCC) is now part of the French National Cancer Institute. The project involves the development and updating of evidence-based Clinical Practice Guidelines (CPG) in oncology. In order to answer questions related to venous thromboembolic events(VTE) treatment and to central venous Catheter Thrombosis (CVCT) management in cancer patients, the SOR elaborated national guidelines, here presented in a short report. It results of a collaborative work with members from three learned societies("societe nationale francaise de medicine interne": SNFMI, "societe francaise de medicine vasculaire": SFMV and "societe francaise dEanesthesie-reanimation:SFAR).