Ancrod, a defibrinogenating thrombin-like enzyme (Malayan pit viper venom), cleaves fibrinopeptide A but not fibrinopeptide B from fibrinogen (Bell, 1997). Ancrod was previously used to treat HIT, especially in Canada (Teasdale et al., 1989; Cole et al., 1990; Demers et al., 1991). However, ancrod does not inhibit— and may even increase—thrombin generation in HIT (Fig. 2) (Warkentin, 1998). Further, its use might predispose to coumarin-induced venous limb gangrene (Warkentin et al., 1997; Gupta et al., 1998). Also, ancrod was less effective than danaparoid in a historically controlled study (Lubenow et al., 2006). The manufacturer discontinued ancrod in 2002.

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