High-dose argatroban therapy for stroke: novel treatment for delayed treatment and the recanalization mechanism

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
Hiroaki IshibashiKenichi Tamura

Abstract

There has been little effective treatment in patients with cerebral infarction at >24 hours after onset. We assessed the effects of high-dose argatroban therapy in delayed administration, and investigated the mechanism based on our clinical findings. Argatroban 30 mg was first administered for 15 minutes intravenously, and then 90 mg for 60 minutes followed by 60 mg for 60 minutes were infused continuously. The change of vascular obstruction caused by the treatment was assessed with magnetic resonance angiography. In 4 patients studied, high-dose argatroban resulted in 100% recanalization of occluded vessels (5/5), even though argatroban was administrated >24 hours after onset. On the other hand, when an inadequate dose of argatroban was administered, a hemorrhage was identified. This supports our hypothesis that high-dose argatroban promotes recanalization by deactivating thrombin and exerting an anticoagulant effect on the vascular endothelium. High-dose argatroban is an effective treatment for cerebral infarction and offers a novel therapeutic approach for delayed hospitalized patients at >24 hours after onset. Additional studies are necessary to identify the cellular and molecular mechanisms and determine the adequate dose ...Continue Reading

References

Nov 1, 1993·Journal of Cardiovascular Pharmacology·M J WinnD D Ku
Mar 30, 1994·Biochemical and Biophysical Research Communications·Y MaruyamaY Soejima
Jan 1, 1997·Seminars in Thrombosis and Hemostasis·S Kobayashi, Y Tazaki
Mar 7, 2002·Neurological Research·Kathryn K LauerAnthony G Hudetz
Jun 18, 2003·Pathophysiology of Haemostasis and Thrombosis·Jawed FareedBruce E Lewis
Jun 3, 2004·Best Practice & Research. Clinical Haematology·Jawed Fareed, Walter P Jeske
Sep 9, 2005·The New England Journal of Medicine·Marcello Di NisioHarry R Büller
Apr 10, 2007·Journal of Neurology·Naohisa HosomiUNKNOWN Japan Standard Stroke Registry Study Group
Sep 18, 2007·Progress in Neurobiology·Chen Xu Wang, Ashfaq Shuaib
Mar 1, 2008·Stroke; a Journal of Cerebral Circulation·Wade S SmithIsaac E Silverman
Dec 20, 2011·Cellular Physiology and Biochemistry : International Journal of Experimental Cellular Physiology, Biochemistry, and Pharmacology·Fan YangMark J Fisher
May 12, 2012·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Hiroaki IshibashiKenichi Tamura

❮ Previous
Next ❯

Citations

May 12, 2012·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Hiroaki IshibashiKenichi Tamura
Dec 17, 2020·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Richard CamaraJohn H Zhang
Feb 9, 2021·Frontiers in Neurology·Nathanael MateiJohn H Zhang

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.