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Self-propelling thrombin powder enables hemostasis with no observable recurrent bleeding or thrombosis over 3 days in a porcine model of upper GI bleeding - 14/07/23

Doi : 10.1016/j.gie.2023.04.007 
Nabil Ali-Mohamad, BASc 1, Massimo F. Cau, PhD 1, 2, Veronika Zenova, BASc 1, James R. Baylis, PhD 3, Andrew Beckett, MD 4, 5, Andrew McFadden, MD 6, Fergal Donnellan, MD 7, Christian J. Kastrup, PhD 1, 8, 9, 10,
1 Michael Smith Laboratories 
2 School of Biomedical Engineering 
6 Department of Surgery 
7 Division of Gastroenterology 
8 Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, British Columbia, Canada 
3 CoMotion Drug Delivery Systems Inc, Vancouver, British Columbia, Canada 
4 Royal Canadian Medical Service, Ottawa, Ontario, Canada 
5 Department of Surgery, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada 
9 Versiti Blood Research Institute, Milwaukee, Wisconsin, USA 
10 Departments of Surgery, Biochemistry, Biomedical Engineering, and Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA 

Reprint requests: Christian J. Kastrup, PhD, Versiti Blood Research Institute, 8727 W Watertown Plank Rd, Milwaukee, WI 53226.Versiti Blood Research Institute8727 W Watertown Plank RdMilwaukeeWI53226

Abstract

Background and Aims

Hemostatic powders used to manage upper GI bleeding continue to exhibit high recurrent bleeding rates. Previously, self-propelling thrombin powder (SPTP) sprayed endoscopically managed severe Forrest class 1A bleeding. Here, we evaluate SPTP in a 3-day recovery model of diffuse ulcerated bleeding.

Methods

Five anesthetized pigs underwent an endoscopic mucosal snare resection to trigger diffuse ulcer bleeding and were treated with SPTP. The time to hemostasis and the amount of powder delivered were measured. Pigs were recovered and monitored.

Results

Five pigs achieved hemostasis in 4.5 ± 1.2 minutes At 3 days after the procedure, the pigs were rescoped and showed no recurrent bleeding. Measured blood parameters were not significantly different from baseline. There were no signs of foreign bodies or thromboembolism during gross necropsy and histopathology of key organs.

Conclusions

SPTP is a promising novel material that stopped diffuse ulcer bleeding in 5 pigs without recurrent bleeding or adverse local or systemic events.

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Abbreviations : SPTP, TXA


Mappa


 DISCLOSURE: The following authors disclosed financial relationships: N. Ali-Mohamad: Employee of CoMotion Drug Delivery Systems Inc. M. F. Cau: Shareholder in CoMotion Drug Delivery Systems Inc. J. R. Baylis: Director of and shareholder in CoMotion Drug Delivery Systems Inc. F. Donnellan: Advisor for CoMotion Drug Delivery Systems Inc. C. J. Kastrup: Director of and shareholder in CoMotion Drug Delivery Systems Inc, NanoVation Therapeutics, and SeraGene Therapeutics. All other authors disclosed no financial relationships. Research support for this study was provided by an American Society of Gastrointestinal Endoscopy Research Award, the Canadian Institutes of Health Research (PJT-175044), the U.S. Department of Defense (W81XWH-21-1-0969), and the Center for Blood Research.


© 2023  American Society for Gastrointestinal Endoscopy. Tutti i diritti riservati.
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P. 245-248 - agosto 2023 Ritorno al numero
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