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An architecturally rational hemostat for rapid control of massive bleeding on anticoagulation therapy

Publication Details

Lee VK, Lee T, Ghosh A, Saha T, Bais MV, Bharani KK, Chag M, Parikh K, Bhatt P, Namgung B, Venkataramanan G. An architecturally rational hemostat for rapid stopping of massive bleeding on anticoagulation therapy. Proceedings of the National Academy of Sciences. 2024 Jan 30;121(5):e2316170121.

Key Findings

  1. Hemostasis Mechanisms of Axiostat at the molecular level
  2. How does Axiostat control massive bleeding in patient on anticoagulation therapy
  3. Superior hemostasis efficacy of Axiostat compared to competing products including kaolin gauze, chitosan coated gauze.

Core Results

Faster Hemostasis & Reduction of blood loss

  • Axiostat significantly reduces compression time by ~50% compared to Kaolin gauze to effectively achieving faster hemostasis in the swine carotid artery bleeding model for severe hemorrhage.
  • Axiostat also reduces the blood loss during haemostasis process significantly by 2x compared to kaolin gauze.

Charge based electrostatic interaction

Axiostat has ~2x higher positive surface charge than competitor kaolin based hemostats which helps in the capturing of major blood clotting components within the Axiostat dressing for quick hemostasis.

Blood Clotting Cascade Activation

Axiostat dressing exhibited significantly higher FXa activity compared to chitosan-coated gauze and kaolin gauze which assists in the faster thrombin generation for rapid blood clotting process.

Robust Fibrin Microthrombi (Plug) Formation

Axiostat showed ~60x higher (1/BCI) value than kaolin gauze, indicating rapid and robust plug formation at the bleeding site to control massive bleeding.

Key Insights & Discussion

  • The Hemostasis Mechanisms of Axiostat involves 4 major steps including charge-based interaction with blood components, platelet activation via Toll-like receptors (TLR), Clotting cascade activation (Factor X) and robust fibrin plug formation at bleeding sites.
  • As anticoagulant drugs do not interact with TLR receptors of platelets, Axiostat can control massive bleeding even in patients under anticoagulation therapy.
  • Axiostat stands out as the most effective advanced hemostatic dressing by demonstrating superior efficacy in rapid hemostasis and minimizing blood loss significantly in comparison with other marketed hemostats utilizing kaolin, cellulose, coatings or impregnation of chitosan granules.
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