Research Article
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Ankaferd® Kanama Durdurucunun Beyin Parankiminde Hemostatik Etkisi: Deneysel Çalışma

Year 2022, Volume: 6 Issue: 1, 31 - 37, 28.04.2022
https://doi.org/10.29058/mjwbs.1058381

Abstract

Amaç: Hemostaz, ameliyatın başarısı için hayati bir aşamadır. Düşük maliyetli ve güvenilir bir ajan olan Ankaferd kanama durdurucu (AKD)
pek çok ameliyatta kullanılmasına rağmen henüz kafa içi bölgede kullanıma sunulmamıştır. Bu çalışma, AKD’nun sitotoksik etkilerini ve
memeli beyin parankimasında güvenlik profilini ortaya çıkarmayı amaçlamaktadır.
Gereç ve Yöntemler: 30 Wistar Albino sıçan, 10 sıçandan oluşan üç gruba ayrıldı. Beyin parankim hasarına bağlı kanamalarda grup 1’de
salin, grup 2’de %50 seyreltilmiş AKD ve grup 3’te %100 AKD ile hemostaz sağlandı. Ameliyat öncesi ve sakrifiye edilirken alınan kan
örneklerinde ürotensin, Antitrombin III (AT3) ve fibrinojen çalışıldı. Ayrıca sıçanların sakrifiye edilmesinden sonra histolojik inceleme yapıldı
ve yaralanma skorları değerlendirildi.
Bulgular: Ameliyat öncesi alınan kan örneklerinde grup 2 ve 3’teki fibrinojen düzeyleri grup 1’e göre anlamlı derecede yüksekti. Her üç
grupta da ameliyat öncesi döneme kıyasla sakrifikasyon sırasında ürotensin’de önemli bir artış vardı. (p=0,005) Grup 2’de hafif yaralanma,
grup 3’te hafif yaralanma ve grup 1’de ciddi yaralanma istatistiksel olarak anlamlı derecede yüksekti. (p=0.005) Bu sonuçlar %50 seyreltilmiş
AKD kullanımının güvenli olduğunu göstermektedir.
Sonuç: Memeli beyin parankiminde ilk kez kullanılan AKD, sıçanlarda güvenli olarak değerlendirildi. Hemostatik matriks ajanlarla
karşılaştırıldığında, güvenlik ve etkinliğe ek olarak, düşük maliyeti gelecekte klinik kullanımını artırabilir.

Supporting Institution

Pamukkale Üniverstesi Bilimsel Araştırma Projesi Koordinatörlüğü Hızlı Destek Projesi

Project Number

2020HZDP016

Thanks

Yok

References

  • 1. Garber A, Jang S. Novel therapeutic strategies in the management of non-variceal upper gastrointestinal bleeding. Clin Endos 2016;49:421-424.
  • 2. Göker H, Haznedaroğlu IC, Erçetin S, Kirazlı S, Akman U, Öztürk Y, Fırat HC. Haemostatic actions of the folkloric medicinal plant extract Ankaferd Blood Stopper. J Int Med Res 2008;36:163-170.
  • 3. Emrah K, Ali AH, Utku O, Murat K, Kenan S, Deniz B. Efficacy of tranexamic acid on blood loss in thoracolumbar spinal fusion surgery. J Coll Physicians Surg Pak 2021;31(12):1449-1454.
  • 4. Keskin E, Aydın HA, Kalaycı M, Işık E, Özgen U, Şimşek K, Baklacı D, Gökçe M. The histopathological effects of reabsorbable polyethylene glycol hydrogel (Coseal) on epidural fibrosis in an experimental postlaminectomy model in rats. Turk J Med Sci 2021;51(3):1512-1520.
  • 5. Kamamoto D, Kanazawa T, Ishihara E, Yanagisawa K, Tomita H, Ueda R, Jinzaki M, Yoshida K, Toda M. Efficacy of a topical gelatin-thrombin hemostatic matrix, FLOSEAL®, in intracranial tumor resection. Surg Neurol Int 2020;11:16.
  • 6. Dinçol ME, Özbaş H, Yılmaz B, Ersev H, Gökyay S, Olgaç V. Effect of the plant-based hemostatic agent Ankaferd Blood Stopper VR on the biocompatibility of mineral trioxide aggregate. BMC Oral Health 2016;16:111.
  • 7. Uğur A, Saraç N, Çankal DA, Özle M. The antioxidant and antimutagenic activities of Ankaferd blood stopper, a natural hemostatic agent used in dentistry. Turk J Med Sci 2016;46:657- 663.
  • 8. Uzun O, Erkan L, Haznedaroğlu IC. Effective management of hemoptysis via endobronchial application of Ankaferd hemostat. Arch Bronconeumol 2014;50:407-409.
  • 9. Atalay H, Atalay A, Doğan OF. Local use of ankaferd blood clotter in emergent beating heart coronary artery bypass grafting. Open Cardiovasc Med J 2015;9:18-25.
  • 10. Ergenoğlu MU, Yerebakan H, Küçükaksu DS. A new practical alternative for the control of sternal bleeding during cardiac surgery: Ankaferd Blood Stopper. Heart Surgery Forum 2010;13(6):379-380.
  • 11. Kurt M, Önal I, Akdoğan M, Kekilli M, Arhan M, Sayılır A, Öztaş E, Haznedaroğlu I. Ankaferd Blood Stopper for controlling gastrointestinal bleeding due to distinct benign lesions refractory to conventional antihemorrhagic measures. Can J Gastroenterol 2010;24:380-384.
  • 12. Heller SJ, Tokar JL, Nguyen MT, Haluszka O, Weinberg DS. Management of bleeding GI tumors. Gastrointest Endosc 2010;72:817-824.
  • 13. Istanbulluoğlu MO, Kaynar M, Ciçek T, Koşan M, Öztürk B, Özkardeş H. A new hemostatic agent (Ankaferd Blood Stopper (VR) in tubeless percutaneous nephrolithotomy: A prospective randomised study. J Endourol 2013;27:1126-1130.
  • 14. Yalçınkaya FR, Kerem M, Güven EO, Gökçe A, Davarcı M. The effect of ankaferd to stop bleeding in experimental partial nephrectomy. Bratisl Lek Listy 2011;112:676-678.
  • 15. Huri E, Akgül T, Ayyıldız A, Germiyanoğlu C. Hemostasis in retropubic radical prostatectomy with Ankaferd Blood Stopper: a case report. Kaohsiung J Med Sci 2009;25:445-447.
  • 16. Teker AM, Korkut AY, Gedikli O, Kahya V. Prospective, controlled clinical trial of Ankaferd Blood Stopper in children undergoing tonsillectomy. Int J Pediatr Otorhinolaryngol 2009;73:1742-1745.
  • 17. Meriç Teker A, Korkut AY, Kahya V, Gedikli O. Prospective, randomised, controlled clinical trial of Ankaferd Blood Stopper in patients with acute anterior epistaxis. Eur Arch Otorhinolaryngol 2010;267:1377-1381.
  • 18. Vezeau PJ. Topical hemostatic agents: What the oral and maxillofacial surgeon needs to know. Oral Maxillofac Surg Clin North Am 2016;28:523-532.
  • 19. İşler SC, Demircan S, Çakarer S, Çebi Z, Keskin C, Soluk M, Yüzbaşıoğlu E. Effects of folk medicinal plant extract ankaferd blood stopper on early bone healing. J Appl Oral Sci 2010;18:409-414.
  • 20. Yang Z, Aderemi OA, Zhao Q, Edsall PR, Simovic MO, Lund BJ, Espinoza MD, Woodson AM, Li Y, Cancio LC. Early Complement and Fibrinolytic Activation in a Rat Model of Blast- Induced Multi-Organ Damage. Mil Med 2019;184: 282-290.
  • 21. Erdoğan H, Kelten B, Tunçdemir M, Erturkuner SP, Uzun H, Karaoğlan A. Hemostasis vs epidural fibrosis? A comparative study on an experimental rat model of laminectomy. Neurol Neurochir Pol 2016;50(5):323-30.
  • 22. Yılmaz M, Gülabi D, Güçlü B, Kaya I, Başak K, Baş A. The effect of Ankaferd Blood Stopper? on epidural fibrosis after laminectomy in rats: An experimental study. Turk Neurosurg 2017;27(1):114-118.
  • 23. Kuruoğlu E, Önger ME, Marangoz AH, Kocacan SE, Çokluk C, Kaplan S. Postlaminectomy bone and scar formations in presence of Ankaferd Blood Stopper and Bitter Melon (Momordica Charantia): An experimental study. Turk Neurosurg 2017;27(3):441-446.
  • 24. Okumuş M, Yüksel KZ, Özbağ D, Çıralık H, Yılmaz Z, Gümüşalan Y, Bakan V, Kalender AM. Medicinal plant extract (Ankaferd Blood Stopper) application in deep tissue injuries in rats: histopathological investigation of the effect on regional and systemic tissues. Ulus Travma Acil Cerrahi Derg 2013;19(1):1- 7.
  • 25. Beyazıt Y, Kurt M, Kekilli M, Göker H, Haznedaroğlu IC. Evaluation of hemostatic effects of Ankaferd as an alternative medicine. Alternative Medicine Review 2010;15(4):329-336.
  • 26. Okay M, Öztürk Y, Haznedaroğlu IC. The Antithrombin Effect of Ankaferd Hemostat (ABS) Is Related to the High Iron Content of the Medicine. Clin Appl Thromb Hemost 2019;25:1076029618824416.
  • 27. Özel Demiralp D, Haznedaroğlu İC, Akar N. Functional proteomic analysis of Ankaferd® Blood Stopper. Turk J Haematol 2010;27(2):70-77.
  • 28. Luh HT, Huang AP, Yang SH, Chen CM, Cho DY, Chen CC, Kuo LT, Li CH, Wang KC, Tseng WL, Hsing MT, Yang BS, Lai DM, Tsai JC. Local hemostatic matrix for endoscope-assisted removal of intracerebral hemorrhage is safe and effective. J Formos Med Assoc 2018;117(1):63-70.
  • 29. Ereth MH, Schaff M, Ericson EF, Wetjen NM, Nuttall GA, Oliver WC Jr. Comparative safety and efficacy of topical hemostatic agents in a rat neurosurgical model. Neurosurgery 2008;63(4 Suppl 2):369-372; discussion 372.
  • 30. Fiss I, Danne M, Stendel R. Use of gelatin-thrombin matrix hemostatic sealant in cranial neurosurgery. Neurol Med Chir (Tokyo) 2007;47(10):462-467.
  • 31. Gazzeri R, Galarza M, Conti C, De Bonis C. Incidence of thromboembolic events after use of gelatin-thrombin-based hemostatic matrix during intracranial tumor surgery. Neurosurg Rev 2018;41(1):303-310.
  • 32. Ho MY, Yang SH, Chen CM, Huang AP. Hemostatic thrombingelatin matrix-related intracranial cyst formation. World Neurosurg 2019;126:475-480.
  • 33. Zeiler FA, Kaufmann AM, Silvaggio J. Thrombin hemostatic matrix leading to acute cerebral edema and sterile fluid collection formation post-tumor resection: Two cases. Acta Neurochir (Wien) 2015;157(3):513-516.

The Haemostatic Effects of Ankaferd Blood Stopper® on Mammalian Brain Parenchyma: An Experimental Study

Year 2022, Volume: 6 Issue: 1, 31 - 37, 28.04.2022
https://doi.org/10.29058/mjwbs.1058381

Abstract

Aim: Haemostasis is a vital stage for the success of the surgery. Although Ankaferd Blood Stopper
(ABS), a low-cost and reliable agent, is used in many surgeries, it is not yet available for use in the
intracranial area. This study aims to reveal ABS’s cytotoxic effects and safety profile in mammalian
brain parenchyma.
Material and Methods: 30 Wistar Albino rats were divided into three groups consisting of 10 rats.
Haemostasis was achieved with saline in group 1, 50% diluted ABS in group 2, and 100% ABS in
group 3 in bleeding caused by damage to the brain parenchyma. Urotensin, Antithrombin III (AT3) and
fibrinogen were studied in blood samples taken before surgery and during sacrification. In addition, the
histologic examination was performed after the sacrification of rats and injury scores were assessed.
Results: Fibrinogen levels in groups 2 and 3 were significantly higher than group 1 in blood samples
taken before surgery. There was a significant increase in urotensin during sacrification compared to
the pre-surgical period in all three groups. (p=0.005) Slight injury in group 2, mild injury in group 3, and
severe injury in group 1 were statistically significantly higher. (p=0.005) These results indicate that the
use of 50% diluted ABS is safe.
Conclusion: ABS, used for the first time in the mammalian brain parenchyma, was evaluated as safe
in rats. Compared to haemostatic matrix agents, in addition to safety and efficacy, its low cost might
increase its clinical use in the future.

Project Number

2020HZDP016

References

  • 1. Garber A, Jang S. Novel therapeutic strategies in the management of non-variceal upper gastrointestinal bleeding. Clin Endos 2016;49:421-424.
  • 2. Göker H, Haznedaroğlu IC, Erçetin S, Kirazlı S, Akman U, Öztürk Y, Fırat HC. Haemostatic actions of the folkloric medicinal plant extract Ankaferd Blood Stopper. J Int Med Res 2008;36:163-170.
  • 3. Emrah K, Ali AH, Utku O, Murat K, Kenan S, Deniz B. Efficacy of tranexamic acid on blood loss in thoracolumbar spinal fusion surgery. J Coll Physicians Surg Pak 2021;31(12):1449-1454.
  • 4. Keskin E, Aydın HA, Kalaycı M, Işık E, Özgen U, Şimşek K, Baklacı D, Gökçe M. The histopathological effects of reabsorbable polyethylene glycol hydrogel (Coseal) on epidural fibrosis in an experimental postlaminectomy model in rats. Turk J Med Sci 2021;51(3):1512-1520.
  • 5. Kamamoto D, Kanazawa T, Ishihara E, Yanagisawa K, Tomita H, Ueda R, Jinzaki M, Yoshida K, Toda M. Efficacy of a topical gelatin-thrombin hemostatic matrix, FLOSEAL®, in intracranial tumor resection. Surg Neurol Int 2020;11:16.
  • 6. Dinçol ME, Özbaş H, Yılmaz B, Ersev H, Gökyay S, Olgaç V. Effect of the plant-based hemostatic agent Ankaferd Blood Stopper VR on the biocompatibility of mineral trioxide aggregate. BMC Oral Health 2016;16:111.
  • 7. Uğur A, Saraç N, Çankal DA, Özle M. The antioxidant and antimutagenic activities of Ankaferd blood stopper, a natural hemostatic agent used in dentistry. Turk J Med Sci 2016;46:657- 663.
  • 8. Uzun O, Erkan L, Haznedaroğlu IC. Effective management of hemoptysis via endobronchial application of Ankaferd hemostat. Arch Bronconeumol 2014;50:407-409.
  • 9. Atalay H, Atalay A, Doğan OF. Local use of ankaferd blood clotter in emergent beating heart coronary artery bypass grafting. Open Cardiovasc Med J 2015;9:18-25.
  • 10. Ergenoğlu MU, Yerebakan H, Küçükaksu DS. A new practical alternative for the control of sternal bleeding during cardiac surgery: Ankaferd Blood Stopper. Heart Surgery Forum 2010;13(6):379-380.
  • 11. Kurt M, Önal I, Akdoğan M, Kekilli M, Arhan M, Sayılır A, Öztaş E, Haznedaroğlu I. Ankaferd Blood Stopper for controlling gastrointestinal bleeding due to distinct benign lesions refractory to conventional antihemorrhagic measures. Can J Gastroenterol 2010;24:380-384.
  • 12. Heller SJ, Tokar JL, Nguyen MT, Haluszka O, Weinberg DS. Management of bleeding GI tumors. Gastrointest Endosc 2010;72:817-824.
  • 13. Istanbulluoğlu MO, Kaynar M, Ciçek T, Koşan M, Öztürk B, Özkardeş H. A new hemostatic agent (Ankaferd Blood Stopper (VR) in tubeless percutaneous nephrolithotomy: A prospective randomised study. J Endourol 2013;27:1126-1130.
  • 14. Yalçınkaya FR, Kerem M, Güven EO, Gökçe A, Davarcı M. The effect of ankaferd to stop bleeding in experimental partial nephrectomy. Bratisl Lek Listy 2011;112:676-678.
  • 15. Huri E, Akgül T, Ayyıldız A, Germiyanoğlu C. Hemostasis in retropubic radical prostatectomy with Ankaferd Blood Stopper: a case report. Kaohsiung J Med Sci 2009;25:445-447.
  • 16. Teker AM, Korkut AY, Gedikli O, Kahya V. Prospective, controlled clinical trial of Ankaferd Blood Stopper in children undergoing tonsillectomy. Int J Pediatr Otorhinolaryngol 2009;73:1742-1745.
  • 17. Meriç Teker A, Korkut AY, Kahya V, Gedikli O. Prospective, randomised, controlled clinical trial of Ankaferd Blood Stopper in patients with acute anterior epistaxis. Eur Arch Otorhinolaryngol 2010;267:1377-1381.
  • 18. Vezeau PJ. Topical hemostatic agents: What the oral and maxillofacial surgeon needs to know. Oral Maxillofac Surg Clin North Am 2016;28:523-532.
  • 19. İşler SC, Demircan S, Çakarer S, Çebi Z, Keskin C, Soluk M, Yüzbaşıoğlu E. Effects of folk medicinal plant extract ankaferd blood stopper on early bone healing. J Appl Oral Sci 2010;18:409-414.
  • 20. Yang Z, Aderemi OA, Zhao Q, Edsall PR, Simovic MO, Lund BJ, Espinoza MD, Woodson AM, Li Y, Cancio LC. Early Complement and Fibrinolytic Activation in a Rat Model of Blast- Induced Multi-Organ Damage. Mil Med 2019;184: 282-290.
  • 21. Erdoğan H, Kelten B, Tunçdemir M, Erturkuner SP, Uzun H, Karaoğlan A. Hemostasis vs epidural fibrosis? A comparative study on an experimental rat model of laminectomy. Neurol Neurochir Pol 2016;50(5):323-30.
  • 22. Yılmaz M, Gülabi D, Güçlü B, Kaya I, Başak K, Baş A. The effect of Ankaferd Blood Stopper? on epidural fibrosis after laminectomy in rats: An experimental study. Turk Neurosurg 2017;27(1):114-118.
  • 23. Kuruoğlu E, Önger ME, Marangoz AH, Kocacan SE, Çokluk C, Kaplan S. Postlaminectomy bone and scar formations in presence of Ankaferd Blood Stopper and Bitter Melon (Momordica Charantia): An experimental study. Turk Neurosurg 2017;27(3):441-446.
  • 24. Okumuş M, Yüksel KZ, Özbağ D, Çıralık H, Yılmaz Z, Gümüşalan Y, Bakan V, Kalender AM. Medicinal plant extract (Ankaferd Blood Stopper) application in deep tissue injuries in rats: histopathological investigation of the effect on regional and systemic tissues. Ulus Travma Acil Cerrahi Derg 2013;19(1):1- 7.
  • 25. Beyazıt Y, Kurt M, Kekilli M, Göker H, Haznedaroğlu IC. Evaluation of hemostatic effects of Ankaferd as an alternative medicine. Alternative Medicine Review 2010;15(4):329-336.
  • 26. Okay M, Öztürk Y, Haznedaroğlu IC. The Antithrombin Effect of Ankaferd Hemostat (ABS) Is Related to the High Iron Content of the Medicine. Clin Appl Thromb Hemost 2019;25:1076029618824416.
  • 27. Özel Demiralp D, Haznedaroğlu İC, Akar N. Functional proteomic analysis of Ankaferd® Blood Stopper. Turk J Haematol 2010;27(2):70-77.
  • 28. Luh HT, Huang AP, Yang SH, Chen CM, Cho DY, Chen CC, Kuo LT, Li CH, Wang KC, Tseng WL, Hsing MT, Yang BS, Lai DM, Tsai JC. Local hemostatic matrix for endoscope-assisted removal of intracerebral hemorrhage is safe and effective. J Formos Med Assoc 2018;117(1):63-70.
  • 29. Ereth MH, Schaff M, Ericson EF, Wetjen NM, Nuttall GA, Oliver WC Jr. Comparative safety and efficacy of topical hemostatic agents in a rat neurosurgical model. Neurosurgery 2008;63(4 Suppl 2):369-372; discussion 372.
  • 30. Fiss I, Danne M, Stendel R. Use of gelatin-thrombin matrix hemostatic sealant in cranial neurosurgery. Neurol Med Chir (Tokyo) 2007;47(10):462-467.
  • 31. Gazzeri R, Galarza M, Conti C, De Bonis C. Incidence of thromboembolic events after use of gelatin-thrombin-based hemostatic matrix during intracranial tumor surgery. Neurosurg Rev 2018;41(1):303-310.
  • 32. Ho MY, Yang SH, Chen CM, Huang AP. Hemostatic thrombingelatin matrix-related intracranial cyst formation. World Neurosurg 2019;126:475-480.
  • 33. Zeiler FA, Kaufmann AM, Silvaggio J. Thrombin hemostatic matrix leading to acute cerebral edema and sterile fluid collection formation post-tumor resection: Two cases. Acta Neurochir (Wien) 2015;157(3):513-516.
There are 33 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Article
Authors

Emrah Egemen 0000-0003-4930-4577

Ümit Akın Dere 0000-0002-6678-6224

Başak Ünver Koluman 0000-0003-1106-5021

Yücel Doğruel This is me 0000-0003-4314-5579

Ahmet Koluman 0000-0001-5308-8884

Batuhan Bakırarar 0000-0002-5662-8193

Nazlı Çil 0000-0002-2164-8688

Esin Avcı 0000-0002-9173-0142

Emine Tural 0000-0003-3624-1378

Fatih Yakar 0000-0001-7414-3766

Project Number 2020HZDP016
Publication Date April 28, 2022
Acceptance Date March 7, 2022
Published in Issue Year 2022 Volume: 6 Issue: 1

Cite

Vancouver Egemen E, Dere ÜA, Ünver Koluman B, Doğruel Y, Koluman A, Bakırarar B, Çil N, Avcı E, Tural E, Yakar F. The Haemostatic Effects of Ankaferd Blood Stopper® on Mammalian Brain Parenchyma: An Experimental Study. Med J West Black Sea. 2022;6(1):31-7.

Medical Journal of Western Black Sea is a scientific publication of Zonguldak Bulent Ecevit University Faculty of Medicine.

This is a refereed journal, which aims at achieving free knowledge to the national and international organizations and individuals related to medical sciences in publishedand electronic forms.

This journal is published three annually in April, August and December.
The publication language of the journal is Turkish and English.