Why the study?
Does the use of dextran-40 during PTCA cause severe anaphylactoid reactions?
Does the use of dextran-40 during PTCA cause severe anaphylactoid reactions?
The routine use of dextran-40 during PTCA is questioned due to the risk of severe, potentially life-threatening anaphylactoid reactions.
May warrant caution with routine dextran-40 in PTCA; leaves open need for prospective trials to guide alternatives.
Successful percutaneous transluminal coronary angioplasty is achieved by fracture of the atheromatous plaque and perhaps dilatation of the arterial walls to increase the luminal diameter of the artery. Because this "controlled" injury stimulates platelet adhesion on the subendothelial matrix, the use of dextran-40 in addition to heparin has been advocated. The overall incidence of Dextran-induced anaphylactoid reactions at our institution was 0.6% and of severe life-threatening reactions, 0.2%. With the recent doubts cast on the efficacy of dextran-40, the question arises regarding its routine use in PTCA.
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Brown et al. (1985) studied this question.
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