1971
DOI: 10.1111/j.1365-2141.1971.tb07061.x
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Epsilon‐Aminocaproic Acid Therapy for Dental Extractions in Haemophilia and Christmas Disease: A Double Blind Controlled Trial

Abstract: Summary. The results are reported of a pilot study and two separate double blind controlled trials of the effectiveness of epsilon‐aminocaproic acid (EACA) in dental extractions in patients with haemophilia and Christmas disease. In the major trial 31 patients were studied; 23 at Oxford and eight at Cardiff. All patients received either EACA (6 g four times daily for 10 days at Oxford or for 7 days at Cardiff) or a placebo, in conjunction with a single preoperative dose of therapeutic materials expected to ra… Show more

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Cited by 143 publications
(81 citation statements)
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“…These acids are effective for treating primary menorrhagia, 69 upper gastrointestinal bleeding, 70 and mucosal bleeding in patients with coagulation disorders or thrombocytopenia. 71 Because these drugs primarily inhibit fibrinolysis, they are more suitable for clot stabilization than for the promotion clot formation. Clinical trials and large observational studies indicate that these agents reduce the frequency of rebleeding after aneurysmal subarachnoid hemorrhage but increase the frequency of delayed cerebral ischemia and other thrombotic complications, resulting in no overall benefit on outcome.…”
Section: Hemostatic Agents: Therapeutic Optionsmentioning
confidence: 99%
“…These acids are effective for treating primary menorrhagia, 69 upper gastrointestinal bleeding, 70 and mucosal bleeding in patients with coagulation disorders or thrombocytopenia. 71 Because these drugs primarily inhibit fibrinolysis, they are more suitable for clot stabilization than for the promotion clot formation. Clinical trials and large observational studies indicate that these agents reduce the frequency of rebleeding after aneurysmal subarachnoid hemorrhage but increase the frequency of delayed cerebral ischemia and other thrombotic complications, resulting in no overall benefit on outcome.…”
Section: Hemostatic Agents: Therapeutic Optionsmentioning
confidence: 99%
“…Indeed, in a controlled trial of antifibrinolytic therapy in hemophilia, patients undergoing dental extractions characteristically bled from tooth sockets after 3 to 5 days, whereas bleeding was completely prevented in patients receiving the antifibrinolytic agent -aminocaproic acid (ACA). 72 This lysine analogue acts very similar to TAFIa in that it inhibits plasmin formation by preventing the binding of plasminogen to C-terminal Lysine residues on partially degraded fibrin that are required for efficient plasmin formation. These observations support the idea that the severe bleeding disorder in hemophilia patients may be attributable to triple defect: (1) reduced thrombin generation via the extrinsic pathway at low tissue factor concentrations; (2) a reduced secondary burst of thrombin generation via the intrinsic pathway, and (3) a defective downregulation of the fibrinolytic system by the intrinsic pathway.…”
Section: Antifibrinolytic Treatment For Hemophiliamentioning
confidence: 99%
“…Tranexamic acid in an oral soak helps stop postoperative bleeding from surgical wounds. Postoperative use of epsilon-aminocaproic acid can considerably diminish the level of factor compulsory to control bleeding when used in conjunction with pre surgical infusion of factor VIII concentrate (Webster et al, 1973;Walsh et al, 1971;Walsh et al, 1975). Hemophilia B is the consequence of factor IX deficiency.…”
Section: Types Of Bleeding Disordersmentioning
confidence: 99%