Intravenous ancrod for acute ischaemic stroke in the European Stroke Treatment with Ancrod Trial: a randomised controlled trial

Lancet. 2006 Nov 25;368(9550):1871-8. doi: 10.1016/S0140-6736(06)69776-6.


Background: Intravenous tissue plasminogen activator is the only approved specific treatment for acute ischaemic stroke. Ancrod, a natural defibrinogenating agent from snake venom, has proved to have a favourable effect when given within 3 h after an acute ischaemic stroke. The European Stroke Treatment with Ancrod Trial was undertaken to assess the effects of ancrod when given within 6 h.

Methods: 1222 patients with an acute ischaemic stroke were included in this randomised double-blind placebo-controlled trial. Brain CT scans were done to exclude intracranial haemorrhages and large evolving ischaemic infarctions. Patients were randomly assigned ancrod (n=604) or placebo (n=618). The primary outcome was functional success at 3 months (survival, Barthel Index of 95 or 100, or return to prestroke level). The analysis was by intention-to-treat. This trial is registered with, trial number NCT00343174.

Findings: Functional success at 3 months did not differ between patients given ancrod (42%) and those given placebo (42%) (p=0.94, OR=0.99, 95% CI, 0.76-1.29).

Interpretation: On the basis of our findings, ancrod should not be recommended for use in acute ischaemic stroke beyond 3 h.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Ancrod / administration & dosage
  • Ancrod / therapeutic use*
  • Anticoagulants / administration & dosage
  • Anticoagulants / therapeutic use*
  • Double-Blind Method
  • Female
  • Humans
  • Infusions, Intravenous
  • Male
  • Stroke / drug therapy*
  • Stroke / mortality
  • Treatment Outcome


  • Anticoagulants
  • Ancrod

Associated data