Use of Purastat in Management of Gastro-Intestinal Bleeding: Our Experience

Aims Many possible causes of bleeding from upper and lower gastro-intestinal (GI) tract, are burdened by significant morbidity and mortality. Lately innovative topical hemostatic agents have been developed for endoscopic use. The aim of report is demonstrate efficacy and safety of PuraStat, a new absorbable hemostatic, to control, alone or in association with a second hemostatic technique, an active GI bleeding.

Methods From October 2018 to September 2020, we observed a case series of 24 patients (15 males, 9 females; range age 44-87 years; mean age 69.8 years) admitted to our Digestive Endoscopy Unit, with anemization due to an active GI bleeding. In particular, 10 patients showed melena and 3 had hematemesis for gastric or duodenal active peptic ulcer, 2 patients had melena after Vater ampulla’s sphincterotomy, 9 patients presented hematochezia after polipectomy or mucosectomy in the colon. Ten patients were on antiplatelet/anticoagulant therapy (4 aspirin and 6 NOAC). PuraStat, a gel used in GI endoscopy to control venous and arteriolar bleedings, was used for primary haemostasis during emergency endoscopy.

Results In our case series, PuraStat was used alone as first hemostatic technique and was effective in haemostasis in 25 % of cases (6/24), and it was also used as second hemostatic technique after injective or clipping and was effective in haemostasis in 75 % of cases (18/24). In all cases, we used a layer of PuraStat applying in a targeted manner about 2,5 ml. of transparent gel, and complete stable control of bleeding was achieved in all patients. No technical difficulties in application encountered, and no incidences of catheter blockage. No complication or delayed bleeding occurred. There were no instances of allergic reaction.

Conclusions According to our experience, PuraStat is an effective, safe and easy to use hemostatic agent for management in different types of active GI bleeding, reducing risk of delayed bleeding.

Citation: Labianca O, Sica M, Zulli C et al. eP3 USE OF PURASTAT IN MANAGEMENT OF GASTRO-INTESTINAL BLEEDING: OUR EXPERIENCE. Endoscopy 2021; 53: S97.

Publikationsverlauf

Artikel online veröffentlicht:
19. März 2021