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Purpose: The main object of treatment in chronic occlusive arterial disease is to increase blood flow and to prevent progress of ischemic ulcer. In case of the symptoms and signs such as rest pain, ischemic ulcer and gangrene with poor angiographic distal run-off, conservative medical treatment is recommended. Argatroban (Novastan®) has an arginine structure, is the first selective antithrombin in the world, showing the inhibitory effect of thrombin-induced fibrin formation, platelet aggregation and vasoconstriction. Method: From September 1995 to January 1999, 39 patients with chronic anerial occlusion as subjects, ulcers, resting pain and feelings of coldness participated in Novastan treatment in 3 institutions (Department of Surgery, Yeungnam University College of Medicine, Department of Surgery Vascular Division, Ulsan University College of Medicine and Asan Medical Center, Department of Surgery, Gachon Medical School) and 30 patients completed the study: thromboangitis obliterance (TAO) in 19 and atherosclerosis obliterans (ASO) in 11 cases. Administration dose was 20 mg (2 amples, q.d or b.i.d) and medicated for consecutive 4 weeks. To detect the changes of symptoms, ulcer size and occurrence of side effects, inquiries, photography and laboratory tests were checked at prior to medication and 2, 3 and 4 weeks after medication. Result: There were 29 men and 1 women, ranging in age from 18 to 80 years old with mean of 50 years old and in body weight from 44 to 86 kg with mean of 64 kg. Improvement rate on ulcer size and granulation appearance was 73.3% (22 cases/30) and 86.7% (26 cases/30) respectively. General improvement rates were 76.7% (23 cases/30), general safety rates were 97.4% (38 cases/39), and utility rates were 70.0% (21 cases/30). Side effects were observed in 3 cases (7.7%). and abnonnal changes in laboratory tests were observed for 15 items in 9 cases. But there noted no significant side effects and abnonnalities in laboratory tests. Conclusion: Argatroban had a beneficial effect in improving such clinical symptoms as ischemic ulcer. resting pain and the feeling of coldness. accompanying chronic arterial occlusion. it causes no serious side effects and it shows high clinical utility.
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