suloctidil and Thrombophlebitis

Topics: Arterial Occlusive Diseases; Arteriosclerosis; Aspirin; Blood Coagulation Disorders; Blood Platelets; Catheterization; Cerebrovascular Disorders; Coronary Disease; Dipyridamole; Glomerulonephritis; Humans; Sulfinpyrazone; Suloctidil; Thiophenes; Thrombophlebitis; Thrombosis; Ticlopidine; Vascular Diseases; Vascular Surgical Procedures

Suloctidil (200 mg t.i.d.) was compared with placebo in a randomized, double-blind trial to assess its value in preventing deep venous thrombosis (DVT) in high-risk neurosurgical patients, comprising 136 patients with brain or spinal tumour, head or spinal injury, or subarachnoid or intracranial hemorrhage. 125I fibrinogen leg scanning and impedance plethysmography were performed for up to 14 days to detect DVT. The two groups were also evenly balanced for DVT risk factors. Seventeen of 68 patients (25%) (95% confidence interval, 15-35%) treated with suloctidil and 12 of 68 patients (21%) (95% confidence interval, 11-32%) treated with placebo developed deep venous thrombosis. This observed difference in outcomes is not statistically significant (X2 = 1.096; p = 0.30). The estimated 95% confidence interval for the true difference in the incidence of DVT between suloctidil-treated and placebo-treated patients ranges from an 11% benefit in favour of suloctidil to an 18% benefit in favour of placebo. Major deep vein thrombosis occurred in two patients on suloctidil and three patients in the placebo group; there were no fatal pulmonary emboli during the 14-day study period, during which time four patients in each group died of non-thromboembolic complications. There was no observed difference in hemorrhagic complications. Long-term outcomes at three-months follow-up were similar between the two treatment groups. It is concluded that there is no real evidence that suloctidil (200 mg t.i.d.) is an effective regimen for the prevention of DVT in high-risk neurosurgical patients.

Topics: Brain Neoplasms; Central Nervous System; Cerebral Hemorrhage; Craniocerebral Trauma; Female; Humans; Male; Middle Aged; Postoperative Complications; Propanolamines; Risk; Spinal Cord Injuries; Spinal Cord Neoplasms; Suloctidil; Thrombophlebitis

A double blind cross over study with suloctidil (Sulocton, Continental Pharma) and placebo was carried out for 6 months in 31 patients with idiopathic recurrent vein thrombosis. They were previously unsuccessfully treated with vitamin K antagonists (VKA) (18 patients) or acetylsalicylic acid (ASA) (13 patients) combined or not the a fibrinolysis activator (theophylline nicotinate). Clinical features, ultrasonic venous flow and biological parameters were controlled monthly during the 6 month treatment. Relevant improvement of clinical, ultrasonic and biological parameters was only observed under suloctidil therapy: during placebo administration 12 patients developed new thrombotic events complicated in 2 by pulmonary embolism while none occurred under suloctidil therapy.

Topics: Adult; Aged; Antigens; beta-Thromboglobulin; Blood Platelets; Cell Survival; Factor VIII; Female; Humans; Male; Middle Aged; Platelet Factor 4; Platelet Function Tests; Propanolamines; Pulmonary Embolism; Recurrence; Suloctidil; Thrombophlebitis; Ultrasonography; Vitamin K

Modern antithrombotics are no more represented merely by anticoagulants. The experiments with a series of thrombosis models enabled us to redefine several new groups appearing as yet under the name "antiplatelet agents" or "antiaggregants". The group comprises particularly acetylsalicylic acid, dipyridamole, hydroxychloroquine, sulfinpyrazone, clofibrate and suloctidyl. It was demonstrated experimentally that these drugs act predominantly by increasing endothelial stability against various noxious agents. This stabilizing effect, independent on the anticoagulant activity, is present also after the administration of oral anticoagulants in doses by one order lower in comparison with the anticoagulant dosage. In fact, the latter dosage has an opposite effect on endothelium and increases the number of circulating endothelial cells. Nevertheless, this unfavourable effect may be inhibited by suitable endotheloprotective drugs (e. g. prenylamine) and in this way an important portion of bleeding complications after oral anticoagulants may be abolished.

Topics: Animals; Anticoagulants; Blood Vessels; Dose-Response Relationship, Drug; Endothelium; Platelet Aggregation; Prenylamine; Rats; Suloctidil; Thrombophlebitis; Warfarin