title: Demonstration of the histopathological and immunohistochemical effects of a novel hemostatic agent, Ankaferd Blood Stopper, on vascular tissue in a rat aortic bleeding model.
abstract: BACKGROUND
  Ankaferd Blood Stopper® (ABS) is a folkloric medicinal plant extract used as a hemostatic agent in traditional Turkish medicine. This experimental study investigated the histopathological and immunohistochemical effects of ABS on vascular tissue in a rat model of aortic bleeding.
  
  
  METHODS
  Four groups of 11 Wistar albino rats were used. The abdominal aortas of the rats were wounded; an ABS-soaked tampon was applied to rats in Groups 1 and 3, and a plain gauze tampon was applied to rats in Groups 2 and 4 until the bleeding stopped. The bleeding time was recorded. Immediately following sacrificing, the arteriotomy sites from Groups 1 and 2 were removed. The abdominal incisions in Groups 3 and 4 were closed following hemostasis. On Day 7 of the study, Group 3 and 4 rats were sacrificed and the abdominal aorta arteriotomy sites were removed for histopathological and immunohistochemical evaluation.
  
  
  RESULTS
  The mean bleeding time in 15 animals in Groups 2 and 4 was 4.9 ± 0.6 s, and in 22 animals in Groups 1 and 3 was 3.1 ± 0.6 s. Distal aortic occlusion was not observed on either Day 1 or 7 in any group. Significantly more widespread and dense endothelial nitric oxide synthase (eNOS) staining was observed in Group 1 animals than Group 2. On Days 1 and 7 after application of ABS, histopathological changes, consisting of necrosis, inflammation, and endothelial cell loss, in the rat abdominal aortas did not differ between Groups 1 and 2. The basophilic discoloration in the ABS group on the operation day was a result of a foreign body reaction and hemosiderin-loaded histiocyte accumulation, which occurred on Day 7.
  
  
  CONCLUSIONS
  In this study, hemostasis was successfully achieved with ABS in rat abdominal aortas. No histopathological change was found in the rat abdominal aortas between the ABS and control groups on Days 1 and 7. Further studies on the long-term effects of foreign body reactions and hemosiderin-loaded histiocyte accumulation are required.
authors.affiliation: Department of Cardiovascular Surgery, Zonguldak Karaelmas University, Zonguldak, Turkey. ozerkandemir@isnet.net.tr
authors.forename: Ozer
authors.initials: O
authors.lastname: Kandemir
authors.forename: Mustafa
authors.initials: M
authors.lastname: Buyukates
authors.forename: Nilufer Onak
authors.initials: NO
authors.lastname: Kandemir
authors.forename: Erol
authors.initials: E
authors.lastname: Aktunc
authors.forename: Aylin Ege
authors.initials: AE
authors.lastname: Gul
authors.forename: Sanser
authors.initials: S
authors.lastname: Gul
authors.forename: S Akin
authors.initials: SA
authors.lastname: Turan
mesh_terms: D000818:Animals; D001012:Aorta, Abdominal / Q000187:drug effects / Q000293:injuries / Q000378:metabolism / Q000473:pathology; D001760:Bleeding Time; D004730:Endothelium, Vascular / Q000378:metabolism; D005549:Foreign-Body Reaction / Q000473:pathology; D006470:Hemorrhage / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D006490:Hemostatics / Q000494:pharmacology*; D006644:Histiocytes / Q000473:pathology; D007150:Immunohistochemistry; D008297:Male; D052250:Nitric Oxide Synthase Type III / Q000378:metabolism; D008517:Phytotherapy; D010936:Plant Extracts / Q000494:pharmacology*; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000378:metabolism; D051381:Rats; D017208:Rats, Wistar
chemical_list: D006490:Hemostatics; D010936:Plant Extracts; D019408:Platelet Endothelial Cell Adhesion Molecule-1; C539751:ankaferd blood stopper; D052250:Nitric Oxide Synthase Type III