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. 2017 Jun;78(3):215-221.
doi: 10.1055/s-0036-1597277. Epub 2016 Dec 12.

Nano-hemostats and a Pilot Study of Their Use in a Large Animal Model of Major Vessel Hemorrhage in Endoscopic Skull Base Surgery

Alistair Jukes  1   2 , Jae Murphy  1   2 , Sarah Vreugde  1   2 , Alkis Psaltis  1   2 , P J Wormald  1   2
Affiliations

Nano-hemostats and a Pilot Study of Their Use in a Large Animal Model of Major Vessel Hemorrhage in Endoscopic Skull Base Surgery

Alistair Jukes et al. J Neurol Surg B Skull Base. 2017 Jun.

Abstract

Nano-hemostats are synthetic amino acid chains that self-assemble into a scaffold under certain conditions. These have been shown to be effective in stopping bleeding in small animal models of hemorrhage. Proposed mechanisms for their effect are that they form a mesh analogous to the fibrin plug in native hemostasis and that they may potentiate both platelet activation and the coagulation cascade. These may potentially become valuable adjuncts to endoscopic skull base surgery where there is the potential for both major vessel injury and smaller perforator injury to eloquent areas where bipolar cautery may not be suitable. We present a summary of the clinical studies to date and a small pilot study of nano-hemostat in an endoscopic sheep model of major vessel hemorrhage to determine its efficacy in stopping bleeding in this potentially catastrophic complication.

Keywords: endoscopic transsphenoidal surgery; hemorrhage control; internal carotid artery injury; nano-medicine; pituitary surgery.

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Figures

Fig. 1
Fig. 1
Endoscopic trainer model (A) placed on sheep's carotid artery and (B) draped and ready for use.
Fig. 2
Fig. 2
(A) Bleeding from the jugular vein. (B) RADA-16 being applied to the jugular vein. (C) Aneurysm clip across carotid artery and scalpel making linear incision. (D) Arterial hemorrhage from carotid injury.
Fig. 3
Fig. 3
(A) Scanning electron microscope view of RADA-16 scaffold. (B–D) Scanning electron microscope views of erythrocytes and platelets trapped in scaffold of fibrin and RADA-16.
See this image and copyright information in PMC

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