Long-term randomized controlled trial of a novel nanopowder hemostatic agent (TC-325) for control of severe arterial upper gastrointestinal bleeding in a porcine model
| Autor: | Xavier Dray, Samuel A. Giday, David B. Liang, Richard W. Ducharme, D. Rueben, A. N. Kalloo, Eun Ji Shin, K. Moskowitz, Y. Kim, M. I. Canto, Gianfranco Donatelli, Patrick I. Okolo, Devi Mukkai Krishnamurty, D. Hutcheon |
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| Přispěvatelé: | Giday, Sa, Kim, Y, Krishnamurty, Dm, Ducharme, R, Liang, Db, Shin, Ej, Dray, X, Hutcheon, D, Moskowitz, K, Donatelli, G, Rueben, D, Canto, Mi, Okolo, Pi, Kalloo, An. |
| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
Gastrointestinal bleeding medicine.diagnostic_test business.industry medicine.medical_treatment Sus scrofa Gastroenterology Activated clotting time medicine.disease Hemostatics Surgery Catheter Hemostasis Laparotomy medicine Animals Nanoparticles Female Upper gastrointestinal bleeding Embolization Powders Gastrointestinal Hemorrhage business Gastroepiploic Artery Foreign body granuloma |
| Zdroj: | Endoscopy. 43:296-299 |
| ISSN: | 1438-8812 0013-726X |
| DOI: | 10.1055/s-0030-1256125 |
| Popis: | Background and study aim: Endoscopic therapy of brisk upper gastrointestinal bleeding remains challenging. A proprietary nanopowder (TC-325) has been proven to be effective in high pressure bleeding from external wounds. The efficacy and safety of TC-325 were assessed in a survival gastrointestinal bleeding animal model. Method: 10 animals were randomized to treatment or sham. All animals received intravenous antibiotics, H2-blockers and heparin (activated clotting time 2 × normal). In a sterile laparotomy the gastroepiploic vessels were dissected, inserted through a 1-cm gastrotomy, and freely exposed in the gastric lumen, and the exposed vessel lacerated by needle knife. The treatment group received TC-325 by a modified delivery catheter while the sham group received no endoscopic treatment. Time to hemostasis, and mortality at 60 minutes, 24 hours, 48 hours, and 7 days were noted. Necropsy was performed in all animals. Results: Spurting arterial bleeding was achieved in all animals. No control animal showed hemostasis within the first hour compared with 100 % (5 / 5) in the treatment arm (mean 13.8 minutes, P < 0.0079). Durable hemostasis was achieved with no evidence of rebleeding after 1 and 24 hours in 80 % (4 / 5) of the treated animals compared with none in the control group ( P < 0.0098). None of the control animals survived more than 6 hours. Necropsy at 1 week in treated animals revealed healed gastrotomy without foreign body granuloma or embolization to the lung or brain. Conclusion: TC-325 is safe and highly effective in achieving hemostasis in an anticoagulated severe arterial gastrointestinal bleeding animal model. |
| Databáze: | OpenAIRE |
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