OBJECTIVES: Tranexamic acid (t-AMCA) has been shown to cause severe convulsions in humans and cats when applied topically to the central nervous system. We wanted to determine whether pure t-AMCA or fibrin sealant (FS) containing t-AMCA would induce similar effects when applied to the spinal cord in a rat model. METHODS: Following low-thoracic laminectomy, the dura was incised to expose the dorsal surface of the lumbar enlargement. Rats were allocated to one of the following treatments: 1) t-AMCA (10 mg/ml), 2) vehicle (phosphate buffered saline), 3) FS containing t-AMCA, 4) FS containing aprotinin. The response of the rats was evaluated based on neurological and behavioral observations. Additionally, motor function was scored in the rats that had received FS. RESULTS: Application of either 10 mg/ml t-AMCA or FS containing t-AMCA caused severe hind limb spasms that developed into spontaneous generalized convulsions. Two of the three rats that had received FS containing t-AMCA died of respiratory failure. In contrast, application of vehicle or FS containing aprotinin did not cause any abnormal conditions of the animals. CONCLUSION: Tranexamic acid may cause severe complications when used in the central nervous system. Thus, fibrin sealants containing t-AMCA should not be used in neurosurgery.
OBJECTIVES:Tranexamic acid (t-AMCA) has been shown to cause severe convulsions in humans and cats when applied topically to the central nervous system. We wanted to determine whether pure t-AMCA or fibrin sealant (FS) containing t-AMCA would induce similar effects when applied to the spinal cord in a rat model. METHODS: Following low-thoracic laminectomy, the dura was incised to expose the dorsal surface of the lumbar enlargement. Rats were allocated to one of the following treatments: 1) t-AMCA (10 mg/ml), 2) vehicle (phosphate buffered saline), 3) FS containing t-AMCA, 4) FS containing aprotinin. The response of the rats was evaluated based on neurological and behavioral observations. Additionally, motor function was scored in the rats that had received FS. RESULTS: Application of either 10 mg/ml t-AMCA or FS containing t-AMCA caused severe hind limb spasms that developed into spontaneous generalized convulsions. Two of the three rats that had received FS containing t-AMCA died of respiratory failure. In contrast, application of vehicle or FS containing aprotinin did not cause any abnormal conditions of the animals. CONCLUSION:Tranexamic acid may cause severe complications when used in the central nervous system. Thus, fibrin sealants containing t-AMCA should not be used in neurosurgery.
Authors: K Vadivel; Y Kumar; G I Ogueli; S M Ponnuraj; P Wongkongkathep; J A Loo; M S Bajaj; S P Bajaj Journal: J Thromb Haemost Date: 2016-11-19 Impact factor: 5.824
Authors: Irene Lecker; Dian-Shi Wang; Alexander D Romaschin; Mark Peterson; C David Mazer; Beverley A Orser Journal: J Clin Invest Date: 2012-11-26 Impact factor: 14.808
Authors: Michael Sander; Claudia D Spies; Viktoria Martiny; Christoph Rosenthal; Klaus-Dieter Wernecke; Christian von Heymann Journal: Crit Care Date: 2010-08-03 Impact factor: 9.097
Authors: Yogesh Kumar; Kanagasabai Vadivel; Amy E Schmidt; Godwin I Ogueli; Sathya M Ponnuraj; Nalaka Rannulu; Joseph A Loo; Madhu S Bajaj; S Paul Bajaj Journal: Biochemistry Date: 2014-01-13 Impact factor: 3.162