Hemostatic Efficacy of Algan Hemostatic Agent in Renal Vein Incision Model in Rats
Year 2023,
, 13 - 18, 27.04.2023
Dila Şener
,
Zeynep Kerime Şanlı
,
Abdulaziz Abouhosa
,
Deniz Mukaddes Türet
,
Uğur Şeker
Abstract
Background: The aim of this study is to evaluate the acute hemostatic effects of liquid and powder forms of AHA in severe bleeding model of rat renal vein.
Materials and Methods: 10-12 weeks old, 24 male Wistar albino rats were randomly divided into three groups of eight animals each as the control, AHA liquid, AHA powder. The left renal artery and vein were revealed with a 3 cm vertical incision and the tip of the injector was used to puncture renal vein, causing bleeding. In all animals, regular gauze patch was pressed over the incised area for 10 seconds as soon as the bleeding began. Immediately after removing the sponge; physiological saline, AHA liquid and powder were applied with compress to injured site of relevant groups for 2 minutes, respectively. The time was recorded by chronometer and the area was checked after two minutes. Hemostasis that was not achieved after three applications was accepted as failure.
Results: Cessation of the bleeding failed in all rats after three successive 2-minute physiological saline impregnated gauze applications in control group. Among AHA-treated groups, significant hemostasis efficacy was obtained from the liquid form than that of powder. Within first two minutes, bleeding in renal veins of five rats was controlled successfully in liquid group whereas powder group achieved hemostatic success in four rats.
Conclusions: The vessel incision model in our study revealed fast-acting physical hemostatic properties of the liquid and powder formulations of AHA in the renal vein. This natural applicable product could be used to induce hemostasis in rat models of bleeding caused by various renal damages or trauma, and it could also prevent local bleeding in humans. More studies are needed to compare the efficacy of different formulations of the polysaccharide-based herbal product in various organs and surgical models.
Supporting Institution
Yok
Thanks
We thank to the Algan Group Health Services (Algan Group Health Services Import and Export Industry and Trade Limited Company, Istanbul, Turkey) for providing AHA forms.
References
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- 2. Bansal V, Fortlage D, Lee JG, Costantini T, Potenza B, Coimbra R. Hemorrhage is More Prevalent than Brain Injury in Early Trauma Deaths: The Golden Six Hours. Eur J Trauma Emerg Surg. 2009; 35(1): 26-30.
- 3. Oostendorp SEV, Tan ECTH, Geeraedts LMG. Prehospital control of life-threatening truncal and junctional haemorrhage is the ultimate challenge in optimizing trauma care; a review of treatment options and their applicability in the civilian trauma setting. Scand J Trauma Resusc Emerg Med. 2016; 24(1): 110.
- 4. Vyas KS, Saha SP. Comparison of hemostatic agents used in vascular surgery. Expert Opin Biol Ther. 2013; 13(12): 1663-72.
5. Okçu KM, Doğan N, Şençimen M, Korkmaz C, Altuğ HA, İde T, et al. Bir Hemostatik Ajanin (Fastact) Deneysel Rat Modelinde Yara ve Doku İyileşmesi Üzerine Etkisi. Balkan Medical Journal. 2010; 2010(4): 221-6.
- 6. Peng HT. Hemostatic agents for prehospital hemorrhage control: a narrative review. Mil Med Res. 2020; 7(1): 13.
- 7. Schwartz M, Madariaga J, Hirose R, Shaver TR, Sher L, Chari R, et al. Comparison of a new fibrin sealant with standard topical hemostatic agents. Arch Surg. 2004; 139: 1148-54.
- 8. Hanks JB, Kjaergard HK, Hollingsbee DA. A comparison of the haemostatic effect of Vivostat patient-derived fibrin sealant with oxidised cellulose (Surgicel) in multiple surgical procedures. Eur Surg Res. 2003; 35: 439-44.
- 9. Ersoy G, Kaynak MF, Yilmaz O, Rodoplu U, Maltepe F, Gokmen N. Hemostatic effects of microporous polysaccharide hemosphere in a rat model with severe femoral artery bleeding. Adv Ther. 2007; 24(3): 485-92.
- 10. Ward KR, Tiba MH, Holbert WH, Blocher CR, Draucker GT, Proffitt EK, et al. Comparison of a new hemostatic agent to current combat hemostatic agents in a Swine model of lethal extremity arterial hemorrhage. J Trauma. 2007; 63: 276-83.
- 11. Beyazit Y, Kurt M, Kekilli M, Goker H, Haznedaroglu IC. Evaluation of hemostatic effects of Ankaferd as an alternative medicine. Altern Med Rev. 2010; 15: 329-36.
- 12. Albayrak CU, Calişkan U, Haznedaroglu IC, Goker H. Haemostatic actions of the folkloric medicinal plant extract Ankaferd Blood Stopper. J Int Med Res. 2008; 36: 163-70.
- 13. Kose R, Sogut O, Demir T, Koruk I. Hemostatic efficacy of folkloric medicinal plant extract in a rat skin bleeding model. Dermatol Surg. 2012; 38(5): 760-6.
- 14. Alimoğulları M, Akkurt G. Deneysel Dalak Yaralanması Yapılan Ratlarda Hemostatik Ajanların Etkinliğinin Karşılaştırılması. Harran Üniversitesi Tıp Fakültesi Dergisi. 2020; 17(2): 161-66.
- 15. Midi A, Ekici H, Kumandas A, Durmus O, Bodic B, Tiryaki M, et al. Investigation of the effectiveness of algan hemostatic agent in bleeding control using an experimental partial splenectomy model in rats. Marmara Med J. 2019; 32: 27-32.
- 16. Midi A, Kumandaş A, Ekici H, Arda S, Karahan S, Şimşek AK, et al. Investigation of the effectiveness of algan hemostatic agent in renal venous bleeding model in rats. EJMI. 2018; 2(3): 129-32.
- 17. Midi A, Kumandas A, Ekici H, Bayraktar F, Karapirli K, Karahan S, et al. Investigation of the efficacy of algan hemostatic agent in liver laceration model in rats. EJMO. 2019; 3(1): 37-42.
- 18. Midi A, Ozyurek HE, Karahan S, Ekici H, Kumandas A, Turkmen I, et al. Investigation of efficacy of the plant based algan hemostatic agent in hepatectomy bleeding model in rats. EJMI. 2018; 2(4):195–201.
- 19. Şener D, Koçak M, Saraçoğlu R, Deveci U, Karadağ M. Histopathological effects of Algan Hemostatic Agent (AHA) in liver injury model in rats. Hepatology Forum. 2022; 3(1): 16-20.
- 20. Şener D, Aydın A, Cücü E, Adademir T, Türet DM, Karadağ M. Effects of Algan hemostatic agent foam in rat femoral artery injury model: A randomized animal trial. JOSAM. 2022; 6(7): 689-92.
- 21. Thompson T, Ng CF, Tolley D. Renal parenchymal hemostatic aids: Glues and things. Curr Opin Urol. 2003; 13(3): 209-14.
- 22. Rolnik A, Olas B. The Plants of the Asteraceae Family as Agents in the Protection of Human Health. Int J Mol Sci. 2021; 22(6): 3009.
- 23. Taheri A, Mirghazanfari SM, Dadpay M. Wound healing effects of Persian walnut (Juglans regia L.) green husk on the incision wound model in rats. Eur J Transl Myol. 2020; 30(1): 210-18.
- 24. Orhan I, Özçelik B, Aslan S, Kartal M, Karaoglu T, Şener B, et al. Antioxidant and antimicrobial actions of the clubmoss Lycopodium clavatum L. Phytochemistry Reviews. 2007; 6: 189-96.
- 25. Dudzinska D, Bednarska K, Boncler M, Luzak B, Watala C. The influence of Rubus idaeus and Rubus caesius leaf extracts on platelet aggregation in whole blood. Cross-talk of platelets and neutrophils. Platelets. 2016; 27(5): 433-9.
- 26. Karagöz A, Kesici S, Vural A, Usta M, Tezcan B, Semerci T, et al. Cardioprotective effects of Viscum album L. ssp. album (Loranthaceae) on isoproterenol-induced heart failure via regulation of the nitric oxide pathway in rats. Anatol J Cardiol. 2016; 16(12): 923-30.
- 27. Kalus U, Koscielny J, Grigorov A, Schaefer E, Peil H, Kiesewetter H. Improvement of cutaneous microcirculation and oxygen supply in patients with chronic venous insufficiency by orally administered extract of red vine leaves AS 195: a randomized, double-blind, placebo controlled, crossover study. Drugs R D. 2004; 5(2): 63-71.
- 28. Kim IY, Eichel L, Edwards R, Uribe C, Chou DS, Abdelshehid C, et al. Effects of commonly used hemostatic agents on the porcine collecting system. J Endourol. 2007; 21(6): 652-4.
- 29. Kheirabadi BS, Sieber J, Bukhari T, Rudnicka K, Murcin LA, Tuthill D. High-pressure fibrin sealant foam: an effective hemostatic agent for treating severe parenchymal hemorrhage. J Surg Res. 2008; 144(1): 145-50.
- 30. Humphreys MR, Lingeman JE, Terry C, Castle EP, Andrews PE, Gettman MT, et al. Renal injury and the application of polysaccharide hemospheres: a laparoscopic experimental model. J Endourol. 2008; 22(6): 1375-82.
31. Yucel MO, Polat H, Bagcioglu M, Karakan T, Benlioglu C, Cift A, et al. Comparison of the efficacy and histopathological effects of three hemostatic agents in a partial nephrectomy rat model. Int Urol Nephrol. 2016; 48(1): 65-71.
- 32. Richter F, Schnorr D, Deger S, Trk I, Roigas J, Wille A, et al. Improvement of hemostasis in open and laparoscopically performed partial nephrectomy using a gelatin matrix-thrombin tissue sealant (FloSeal). Urology. 2003; 61(1): 73-7.
- 33. Murat FJL, Ereth MH, Dong Y, Piedra MP, Gettman MT. Evaluation of microporous polysaccharide hemospheres as a novel hemostatic agent in open partial nephrectomy: favorable experimental results in the porcine model. J Urol. 2004; 172(3): 1119-22.
- 34. Slezak P, Heher P, Monforte X, Keibl C, Redl H, Spazierer D, et al. Efficacy of Topical Hemostatic Agents: A Comparative Evaluation of Two Gelatin/Thrombin-Based Hemostatic Matrices in a Porcine Kidney Surgical Model. J Invest Surg. 2019; 32(7): 646-53.
- 35. Bang B, Lee E, Maeng J, Kim K, Hwang JH, Hyon SH, et al. Efficacy of a novel endoscopically deliverable muco-adhesive hemostatic powder in an acute gastric bleeding porcine model. PLoS One. 2019; 14(6): 2-9.
- 36. Tuthill DD, Bayer V, Gallagher AM, Drohan WN, MacPhee MJ. Assessment of topical hemostats in a renal hemorrhage model in heparinized rats. J Surg Res. 2001; 95(2): 126-32.
- 37. Germiyanoğlu C, Huri E, Akgül T, Ayyıldız A, Üstün H. Invivo hemostatic effect of ankaferd blood stopper in rat major renal trauma model: Controlled trial of novel hemostatic agent. Uluslararası Hematoloji-Onkoloji Dergisi. 2010; 20(4): 206-11.
Algan Hemostatik Ajan’ın Sıçan Renal Ven İnsizyon Modelinde Hemostatik Etkinliği
Year 2023,
, 13 - 18, 27.04.2023
Dila Şener
,
Zeynep Kerime Şanlı
,
Abdulaziz Abouhosa
,
Deniz Mukaddes Türet
,
Uğur Şeker
Abstract
Amaç: Bu çalışmanın amacı, sıçan renal veninin şiddetli kanama modelinde sıvı ve toz AHA formlarının akut hemostatik etkilerini değerlendirmektir.
Materyal ve metod: 10-12 haftalık, 24 erkek Wistar albino sıçan kontrol, AHA sıvı ve AHA toz olarak her biri sekiz hayvan içeren üç gruba rastgele ayrıldı. Sol renal arter ve ven 3 cm'lik vertikal insizyon ile ortaya çıkarıldı. Renal venin kesi yaralanması için enjektör ucu kullanıldı ve kanamaya neden oldu. Kanama başladığında tüm hayvanlarda insize edilen alan üzerine 10 saniye süresince gazlı bez ile bası uygulandı. Ardından, serum fizyolojik, AHA sıvı ve toz ilgili gruplarda aynı kesi bölgesine sırasıyla iki dakika süreyle uygulandı. Süre kronometre ile kaydedildi ve kanama alanı iki dakika sonar control edildi. Üç uygulama sonrasında hemostaz sağlanamadıysa, başarısız olarak kabul edildi.
Bulgular: Kontrol grubundaki tüm sıçanlarda ardışık 2 dakikalık serum fizyolojik emdirilmiş gazlı bez uygulamalarında kanama durdurulması başarısız oldu. AHA uygulanan gruplarda, sıvı formdan toza göre daha önemli hemostaz etkinliği sağlandı. İlk iki dakika içinde, sıvı grubunda beş sıçanın böbrek damarlarındaki kanama kontrol edilirken, toz grubunda dört sıçanda hemostatik başarı elde edildi.
Sonuç: Çalışmamızdaki damar kesi modeli, renal vende AHA' nın sıvı ve toz formülasyonlarının hızlı etkili fiziksel hemostatik özelliklerini ortaya çıkarmıştır. Bu doğal uygulanabilir ürün, çeşitli böbrek hasarları ya da travmaya bağlı sıçan kanama modellerinde hemostaz sağlamak için kullanılabilir ve ayrıca insanlarda lokal kanamayı önleyebilir. Polisakkarit bazlı bitkisel ürünün farklı formülasyonlarının çeşitli organlarda ve cerrahi modellerde etkinliğini karşılaştırmak için daha fazla çalışmaya ihtiyaç vardır.
References
- 1. Spahn DR, Bouillon B, Cerny V, Duranteau J, Filipescu D, Hunt BJ, et al. The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition. Crit Care. 2019; 23(1): 98.
- 2. Bansal V, Fortlage D, Lee JG, Costantini T, Potenza B, Coimbra R. Hemorrhage is More Prevalent than Brain Injury in Early Trauma Deaths: The Golden Six Hours. Eur J Trauma Emerg Surg. 2009; 35(1): 26-30.
- 3. Oostendorp SEV, Tan ECTH, Geeraedts LMG. Prehospital control of life-threatening truncal and junctional haemorrhage is the ultimate challenge in optimizing trauma care; a review of treatment options and their applicability in the civilian trauma setting. Scand J Trauma Resusc Emerg Med. 2016; 24(1): 110.
- 4. Vyas KS, Saha SP. Comparison of hemostatic agents used in vascular surgery. Expert Opin Biol Ther. 2013; 13(12): 1663-72.
5. Okçu KM, Doğan N, Şençimen M, Korkmaz C, Altuğ HA, İde T, et al. Bir Hemostatik Ajanin (Fastact) Deneysel Rat Modelinde Yara ve Doku İyileşmesi Üzerine Etkisi. Balkan Medical Journal. 2010; 2010(4): 221-6.
- 6. Peng HT. Hemostatic agents for prehospital hemorrhage control: a narrative review. Mil Med Res. 2020; 7(1): 13.
- 7. Schwartz M, Madariaga J, Hirose R, Shaver TR, Sher L, Chari R, et al. Comparison of a new fibrin sealant with standard topical hemostatic agents. Arch Surg. 2004; 139: 1148-54.
- 8. Hanks JB, Kjaergard HK, Hollingsbee DA. A comparison of the haemostatic effect of Vivostat patient-derived fibrin sealant with oxidised cellulose (Surgicel) in multiple surgical procedures. Eur Surg Res. 2003; 35: 439-44.
- 9. Ersoy G, Kaynak MF, Yilmaz O, Rodoplu U, Maltepe F, Gokmen N. Hemostatic effects of microporous polysaccharide hemosphere in a rat model with severe femoral artery bleeding. Adv Ther. 2007; 24(3): 485-92.
- 10. Ward KR, Tiba MH, Holbert WH, Blocher CR, Draucker GT, Proffitt EK, et al. Comparison of a new hemostatic agent to current combat hemostatic agents in a Swine model of lethal extremity arterial hemorrhage. J Trauma. 2007; 63: 276-83.
- 11. Beyazit Y, Kurt M, Kekilli M, Goker H, Haznedaroglu IC. Evaluation of hemostatic effects of Ankaferd as an alternative medicine. Altern Med Rev. 2010; 15: 329-36.
- 12. Albayrak CU, Calişkan U, Haznedaroglu IC, Goker H. Haemostatic actions of the folkloric medicinal plant extract Ankaferd Blood Stopper. J Int Med Res. 2008; 36: 163-70.
- 13. Kose R, Sogut O, Demir T, Koruk I. Hemostatic efficacy of folkloric medicinal plant extract in a rat skin bleeding model. Dermatol Surg. 2012; 38(5): 760-6.
- 14. Alimoğulları M, Akkurt G. Deneysel Dalak Yaralanması Yapılan Ratlarda Hemostatik Ajanların Etkinliğinin Karşılaştırılması. Harran Üniversitesi Tıp Fakültesi Dergisi. 2020; 17(2): 161-66.
- 15. Midi A, Ekici H, Kumandas A, Durmus O, Bodic B, Tiryaki M, et al. Investigation of the effectiveness of algan hemostatic agent in bleeding control using an experimental partial splenectomy model in rats. Marmara Med J. 2019; 32: 27-32.
- 16. Midi A, Kumandaş A, Ekici H, Arda S, Karahan S, Şimşek AK, et al. Investigation of the effectiveness of algan hemostatic agent in renal venous bleeding model in rats. EJMI. 2018; 2(3): 129-32.
- 17. Midi A, Kumandas A, Ekici H, Bayraktar F, Karapirli K, Karahan S, et al. Investigation of the efficacy of algan hemostatic agent in liver laceration model in rats. EJMO. 2019; 3(1): 37-42.
- 18. Midi A, Ozyurek HE, Karahan S, Ekici H, Kumandas A, Turkmen I, et al. Investigation of efficacy of the plant based algan hemostatic agent in hepatectomy bleeding model in rats. EJMI. 2018; 2(4):195–201.
- 19. Şener D, Koçak M, Saraçoğlu R, Deveci U, Karadağ M. Histopathological effects of Algan Hemostatic Agent (AHA) in liver injury model in rats. Hepatology Forum. 2022; 3(1): 16-20.
- 20. Şener D, Aydın A, Cücü E, Adademir T, Türet DM, Karadağ M. Effects of Algan hemostatic agent foam in rat femoral artery injury model: A randomized animal trial. JOSAM. 2022; 6(7): 689-92.
- 21. Thompson T, Ng CF, Tolley D. Renal parenchymal hemostatic aids: Glues and things. Curr Opin Urol. 2003; 13(3): 209-14.
- 22. Rolnik A, Olas B. The Plants of the Asteraceae Family as Agents in the Protection of Human Health. Int J Mol Sci. 2021; 22(6): 3009.
- 23. Taheri A, Mirghazanfari SM, Dadpay M. Wound healing effects of Persian walnut (Juglans regia L.) green husk on the incision wound model in rats. Eur J Transl Myol. 2020; 30(1): 210-18.
- 24. Orhan I, Özçelik B, Aslan S, Kartal M, Karaoglu T, Şener B, et al. Antioxidant and antimicrobial actions of the clubmoss Lycopodium clavatum L. Phytochemistry Reviews. 2007; 6: 189-96.
- 25. Dudzinska D, Bednarska K, Boncler M, Luzak B, Watala C. The influence of Rubus idaeus and Rubus caesius leaf extracts on platelet aggregation in whole blood. Cross-talk of platelets and neutrophils. Platelets. 2016; 27(5): 433-9.
- 26. Karagöz A, Kesici S, Vural A, Usta M, Tezcan B, Semerci T, et al. Cardioprotective effects of Viscum album L. ssp. album (Loranthaceae) on isoproterenol-induced heart failure via regulation of the nitric oxide pathway in rats. Anatol J Cardiol. 2016; 16(12): 923-30.
- 27. Kalus U, Koscielny J, Grigorov A, Schaefer E, Peil H, Kiesewetter H. Improvement of cutaneous microcirculation and oxygen supply in patients with chronic venous insufficiency by orally administered extract of red vine leaves AS 195: a randomized, double-blind, placebo controlled, crossover study. Drugs R D. 2004; 5(2): 63-71.
- 28. Kim IY, Eichel L, Edwards R, Uribe C, Chou DS, Abdelshehid C, et al. Effects of commonly used hemostatic agents on the porcine collecting system. J Endourol. 2007; 21(6): 652-4.
- 29. Kheirabadi BS, Sieber J, Bukhari T, Rudnicka K, Murcin LA, Tuthill D. High-pressure fibrin sealant foam: an effective hemostatic agent for treating severe parenchymal hemorrhage. J Surg Res. 2008; 144(1): 145-50.
- 30. Humphreys MR, Lingeman JE, Terry C, Castle EP, Andrews PE, Gettman MT, et al. Renal injury and the application of polysaccharide hemospheres: a laparoscopic experimental model. J Endourol. 2008; 22(6): 1375-82.
31. Yucel MO, Polat H, Bagcioglu M, Karakan T, Benlioglu C, Cift A, et al. Comparison of the efficacy and histopathological effects of three hemostatic agents in a partial nephrectomy rat model. Int Urol Nephrol. 2016; 48(1): 65-71.
- 32. Richter F, Schnorr D, Deger S, Trk I, Roigas J, Wille A, et al. Improvement of hemostasis in open and laparoscopically performed partial nephrectomy using a gelatin matrix-thrombin tissue sealant (FloSeal). Urology. 2003; 61(1): 73-7.
- 33. Murat FJL, Ereth MH, Dong Y, Piedra MP, Gettman MT. Evaluation of microporous polysaccharide hemospheres as a novel hemostatic agent in open partial nephrectomy: favorable experimental results in the porcine model. J Urol. 2004; 172(3): 1119-22.
- 34. Slezak P, Heher P, Monforte X, Keibl C, Redl H, Spazierer D, et al. Efficacy of Topical Hemostatic Agents: A Comparative Evaluation of Two Gelatin/Thrombin-Based Hemostatic Matrices in a Porcine Kidney Surgical Model. J Invest Surg. 2019; 32(7): 646-53.
- 35. Bang B, Lee E, Maeng J, Kim K, Hwang JH, Hyon SH, et al. Efficacy of a novel endoscopically deliverable muco-adhesive hemostatic powder in an acute gastric bleeding porcine model. PLoS One. 2019; 14(6): 2-9.
- 36. Tuthill DD, Bayer V, Gallagher AM, Drohan WN, MacPhee MJ. Assessment of topical hemostats in a renal hemorrhage model in heparinized rats. J Surg Res. 2001; 95(2): 126-32.
- 37. Germiyanoğlu C, Huri E, Akgül T, Ayyıldız A, Üstün H. Invivo hemostatic effect of ankaferd blood stopper in rat major renal trauma model: Controlled trial of novel hemostatic agent. Uluslararası Hematoloji-Onkoloji Dergisi. 2010; 20(4): 206-11.