Hemostatic Action of OC-108, a Novel Agent for Hemorrhoids, Is Associated With Regional Blood Flow Arrest Induced by Acute Inflammation

Abstract

Abstract. Clinically, hemorrhoidal bleeding and prolapse disappeared immediately after injection of the sclerosing agent OC-108 into submucosa of hemorrhoids. The aim of this study was to elucidate the mechanism of action responsible for the immediate hemostatic effect of OC-108 using anesthetized rats. Subcutaneous injection of OC-108 in rats decreased blood flow at the injection site within 5 min. Aluminum potassium sulfate, one of the main ingredients of OC-108, reduced the skin blood flow. However, tannic acid, another main ingredient, did not. By perfusion of OC-108 on the mesenteric surface, microcirculatory blood flow was arrested without remarkable change in blood vessel diameter, accompanied by increased vascular permeability and venous hematocrit. These results indicate that OC-108 induces regional blood flow arrest with rapid onset, this effect being attributed to the action of aluminum potassium sulfate, and that hemoconcentration due to increased vascular permeability (plasma extravasation), an acute inflammatory reaction, is involved in the mechanisms of the immediate hemostatic action of OC-108.

Gluteal-fold flap repair of rectovaginal fistula caused by aluminum potassium sulfate hydrate-tannic acid injection for internal hemorrhoids: a case report

“…ALTA, a new and effective sclerosant, was developed in Japan and is effective for shrinking and hardening hemorrhoids in order to eliminate prolapse and bleeding [ 1 , 2 ]. ALTA therapy combines aluminum potassium sulfate and tannic acid; the former induces an inflammatory reaction, resulting in strong, local fibrosis, while the latter has a strong astringent effect on tissue, promoting protein coagulation and the contraction of blood vessels while reducing exudation into the tissue from the inflammatory reaction [ 1 , 2 ]. ALTA sclerotherapy is popular as a comparatively simple, minimally invasive treatment for symptomatic internal hemorrhoids in outpatient clinics in Japan [ 3 – 5 ].…”

“…In this case, RVF occurred following aluminum potassium sulfate hydrate and tannic acid (ALTA) therapy for internal hemorrhoids. ALTA (Zion, Mitsubishi Pharma Corp., Osaka, Japan) is a new sclerosant developed in Japan [1,2]. ALTA therapy is effective for shrinking and hardening the hemorrhoids in order to eliminate prolapse and bleeding.…”

Three‐dimensional power Doppler transanal ultrasonography, to monitor haemorrhoidal blood flow after Doppler‐guided ALTA sclerosing therapy

“…The aluminium ion induces a strong local inflammatory reaction, resulting in fibrosis. Tannic acid has a strong astringent effect on tissues, promoting protein coagulation and the contraction of blood vessels, while reducing exudation from the inflammatory reaction [17,18]. These actions tend to prevent necrosis and promote sclerosis, adhesion of haemorrhoidal tissue and immediate haemostasis.…”

Laparoscopic anterior resection for rectal stenosis caused by ALTA injection for internal hemorrhoids: A case report

“…A new and effective sclerosant of aluminum potassium sulfate and tannic acid (ALTA; Zion, Mitsubishi Pharma Corp., Osaka, Japan) was developed in Japan 1,2 . ALTA therapy is effective for shrinking and hardening the hemorrhoids in order to eliminate prolapse and bleeding.…”