The effect of persantin on intercoronary collateral circulation and survival during gradual experimental coronary...

Twenty-five dogs were exposed to gradual coronary occlusion by placing Ameroid constrictors around the origins of the left circumflex and anterior descending coronary arteries. Previous experiments have demonstrated that these constrictors absorb water and, over a period of three weeks, narrow the cross-sectional area of the two arteries to 50% or less, and consequently cause the death of 80% of the experimental animals. Twelve of the 25 animals were fed 50 mg. of Persantin three times a day by mouth commencing one day before the operative procedure. Determinations of the concentration of the drug in the blood revealed a level consistent with that obtained in humans after the administration of therapeutic doses. Eleven of the 13 control animals died in the three-month experimental period while only six of the 12 treated animals expired. Injections of Schlesinger mass in all animals dying or killed following the experimental period demonstrated that Persantin significantly accelerated the development of intercoronary anastomoses in the treated group, and in the surviving animals produced a rich anastomotic network much in excess of that seen in the surviving animals in the control series that were exposed to hypoxia alone. On the basis of these experimental findings, it is suggested that Persantin may favourably alter the prognosis of many patients with coronary artery disease.