Low molecular weight heparin in prevention of restenosis after PTCA

Late restenosis occurring after successful PTCA continues to represent a major problem limiting the clinical efficacy of the procedure. It has been shown that smooth muscle cell proliferation plays a major role in this accelerated atherosclerotic process. In vitro and in vivo experiments with the low molecular weight heparin reviparin showed a pronounced inhibitory effect by this compound on smooth muscle cell proliferation. To evaluate the safety of reviparin and the incidence of angiographic restenosis in humans, a study of increasing dosages was conducted in 41 patients. Repeat coronary angiography was performed 3 months after angioplasty. Restenosis occurred in 5 of 37 evaluable patients with initially successful PTCA. No major bleeding complication was documented for any patient in this first pilot trial. A randomized, double-blind, multicentre trial is being carried out to define the real impact of this compound in reducing restenosis in patients who undergo successful balloon angioplasty.