Splenic artery embolization with Ankaferd blood stopper in a sheep model.

PURPOSE: Splenic artery embolization is a minimally invasive therapeutic procedure utilized in a number of disorders. Ankaferd blood stopper (ABS) is a novel hemostatic agent with a new mechanism of action independent of clotting factors. We aimed to investigate the safety and efficiency of ABS for splenic artery embolization in a sheep model. METHODS: Seven adult female sheep were included in the study. Selective celiac angiography was performed using a 5F diagnostic catheter and then a 2.7F hydrophilic coating microcatheter was advanced coaxially to the distal part of the main splenic artery. Under fluoroscopic guidance, 6 mL mixture composed of half-and-half ABS and contrast agent was slowly injected. Fluoroscopy was used to observe the deceleration and stagnation of the flow. Control celiac angiograms were obtained immediately after the embolization. After the procedure, the animals were observed for one day and then sacrificed with intravenous sodium thiopental. RESULTS: Technical success rate was 100%. None of the animals died or experienced a major systemic adverse event during the procedure. All of the spleens appeared dark on macroscopic examination due to excessive thrombosis. Microscopically, the majority of the splenic sinusoids (90%-95%) were necrotic. CONCLUSION: In our study, splenic artery embolization by ABS was found to be safe and effective in the short-term. Further studies are needed to better understand the embolizing potential of this novel hemostatic agent.

Short-term effects of Ankaferd hemostat for renal artery embolization: an experimental study.

PURPOSE: Renal artery embolization (RAE) is a minimally invasive therapeutic technique that is utilized in a number of disorders. Ankaferd is a novel hemostatic agent with a new mechanism of action independent of clotting factors. We used Ankaferd for RAE in a sheep model. METHODS: Seven adult female sheep were included in the study. Selective renal arteriogram using 5-F diagnostic catheter was performed to make sure that each kidney was fed by a single renal artery and the animal had normal renal vasculature. Coaxial 2.7-F microcatheter was advanced to the distal main renal artery. Under fluoroscopic guidance, 2 mL of Ankaferd mixed with 2 mL of nonionic iodinated contrast agent was slowly injected. Fluoroscopy was used to observe the deceleration of flow and stagnation. Control renal angiograms were performed just after embolization. After the procedure, the animals were observed for 1 day and then sacrificed with intravenous sodium thiopental. RESULTS: The technical success was observed in seven of the seven animals.. After embolization procedure, none of the animals died or experienced a major systemic adverse event. On macroscopic examination of the embolized kidneys, thrombus at the level of main renal artery formed after Ankaferd embolization was more compact compared with the thrombi that was not Ankaferd-associated, which was observed elsewhere. Microscopically, majority of the renal tubular cells (80-90 %) were necrotic, and there was epithelial cell damage in a small portion of the cells (10-20 %). CONCLUSIONS: RAE was safe and effective in the short-term with Ankaferd in studied animals. Further studies should be conducted to better delineate the embolizing potential of this novel hemostatic agent.

Effect of carbon dioxide pneumoretroperitoneum on bacterial translocation in an experimental retroperitoneoscopy model.

PURPOSE: To evaluate the effect of artificial CO2 pneumoretroperitoneum on bacterial translocation in an experimental retroperitoneoscopy model. MATERIALS AND METHODS: Eighteen adult male New Zealand White rabbits weighing 2.5 to 3 kg were divided into two groups. Group 1 (control group) consisted of 6 rabbits, while the remaining 12 served as the pneumoretroperitoneum group (group 2). In group 1, the left retroperitoneal space was dissected with a 50-mL balloon without CO2 insufflation, and the animals were kept under anesthesia for 3 hours with the balloons inflated. In group 2, after balloon dissection as in group 1, CO2 insufflation was applied at 1 L/min to achieve a pressure of 10 to 12 mm Hg for 3 hours. Afterward, all animals were sacrificed, and samples were taken from the blood, retroperitoneal area, lungs, liver, mesentery, heart, kidneys, ureters, bladder, colon, small intestine, and spleen and carried to the microbiology laboratory in Carry-Blair medium. Bacterial growth was evaluated using standard techniques. RESULTS: All animals survived the experimental procedures. None of the rabbits in the control group demonstrated any bacterial translocation in the sampled tissues. In the pneumoretroperitoneum group, one rabbit was found to have 10(2) colony-forming units of E. coli in the kidney, but this was considered to be the result of contamination, not translocation. CONCLUSION: Carbon dioxide pneumoretroperitoneum does not seem to cause bacteremia or bacterial translocation in this experimental model. Retroperitoneoscopy probably does not create any additional risk of septic complications.