Brief report
Instant control of fundal variceal bleeding with a folkloric medicinal plant extract: Ankaferd Blood Stopper

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Case report

A 70-year-old man was admitted to the hospital with upper GI bleeding. He stated that he had vomited fresh blood. He had cirrhosis caused by hepatitis B for the past 3 years. His blood pressure was 85/50 mm Hg and heart rate was 85 beats per minute. His hemoglobin level was 6.9 g/dL, platelet count was 95,000/mm3, serum creatinine was 1.9 mg/dL, prothrombin time was 20.4 seconds (upper limit 16 seconds), and international normalized ratio was 1.45. Somatostatin infusion was started, and 2 units

Discussion

ABS is a derivate of 5 plants. It is locally active on the bleeding surface. When ABS is applied to the bleeding site, it interacts with plasma proteins, forms an encapsulated protein network, and stimulates erythrocyte aggregation.4 The drug does not require injecting; spraying over the bleeding site is sufficient for hemostasis.

Although gastric varices bleed less frequently than esophageal varices, the rebleeding and mortality rates for gastric variceal hemorrhage are higher.3 There is no

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Cited by (31)

  • Endoscopic Diagnosis and Therapy in Gastroesophageal Variceal Bleeding

    2015, Gastrointestinal Endoscopy Clinics of North America
    Citation Excerpt :

    Their use in control of gastrointestinal bleedings including variceal bleeding remains experimental, however. There have been a few case reports with successful use of Ankaferd Blood Stopper (ABS, a plant alkaloid extract) in acute upper gastrointestinal bleedings including gastric variceal bleeding.61,62 Such agents may prove handy as a rescue agent in difficult cases that fail the standard approach of band ligation or glue injections.

  • Topical hemostatic agents: A systematic review with particular emphasis on endoscopic application in GI bleeding

    2013, Gastrointestinal Endoscopy
    Citation Excerpt :

    Purnak et al100 reported successful use of ABS as an adjunctive agent in a thrombocytopenic, coagulopathic patient with a bleeding gastric ulcer. It has also been successfully applied to variceal bleeding, both as a bridge to definitive treatment and as rescue for failed conventional therapy including banding and N-butyl-2-cyanoacrylate.101-104 ABS thus may have a role to play as an alternative therapy in the management of patients with refractory variceal hemorrhage.105

  • Pleiotropic cellular, hemostatic, and biological actions of Ankaferd hemostat

    2012, Critical Reviews in Oncology/Hematology
    Citation Excerpt :

    ABS offers an effective alternative in this setting of gastroesophageal variceal bleeding. In a recent study by Tuncer et al. [49], a patient with fundal variceal bleeding was successfully treated with ABS where instant bleeding control was accomplished in 18 s without any additional treatment required. Post-control endoscopy performed on the 5th day indicated clean surface fundal varices, and a successful variceal obscuration by cyanoacrylate injection was performed subsequently.

  • Emerging technologies for endoscopic hemostasis

    2012, Gastrointestinal Endoscopy
    Citation Excerpt :

    No complications were reported at 30-day follow-up.3 Several single case reports and small case series have described control of acute bleeding with the application of ABS in various GI conditions, such as Mallory-Weiss tears,7 Dieulafoy lesions,7 gastric antral vascular ectasia,7 gastric varices,8-10 anastomotic ulcers,11 sphincterotomy sites,12 postpolypectomy sites,7 radiation proctopathy,7,13 solitary rectal ulcers,14 and tumor bleeding.15-18 As yet, there are no published prospective trials regarding the use of ABS for endoscopic hemostasis.

  • Successful topical application of Ankaferd Blood Stopper in a patient with life-threatening fundal variceal bleeding despite cyanoacrilate injection

    2012, Clinics and Research in Hepatology and Gastroenterology
    Citation Excerpt :

    In this setting, ABS seems to offer an exciting alternative in the treatment of variceal bleeding due to its ease of application, non-toxicity and speed of action. Despite its effectiveness in bleeding control, there is only a small number of reported cases [7,8] in literature in which ABS was applied in bleeding gastric varices. But in both of these cases, ABS was reported to perform as a primary agent, in contrary to our case.

  • Response (with video)

    2011, Gastrointestinal Endoscopy
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