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Ancrod, a proteolytic enzyme derived from the venom of the Malaysian pit viper, has numerous hematologic effects, including cleavage of fibrinogen. It has been evaluated in several acute stroke trials with mostly disappointing results. To evaluate ancrod’s effects when administered within 6 hours of symptom onset, researchers in Europe conducted a randomized, double-blind, placebo-controlled trial. The study, sponsored by the manufacturer of ancrod, included adult patients with moderate-to-severe neurologic deficits that did not improve rapidly and excluded patients with systolic blood pressure >220 mm Hg, diastolic blood pressure >120 mm Hg, or hemorrhage on computed tomography scan.
Overall, 604 patients received ancrod, and 618 received p…