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CC BY 4.0 · Endosc Int Open 2025; 13: a25506677
DOI: 10.1055/a-2550-6677
Letter to the editor

Response to comment on "PuraStat for gastrointestinal bleeding management: Effective approach for endoscopic prevention and rescue therapy"

Roberta Maselli
1   Endoscopy Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy (Ringgold ID: RIN9268)
2   Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy (Ringgold ID: RIN437807)
,
Leonardo Da Rio
1   Endoscopy Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy (Ringgold ID: RIN9268)
,
Cesare Hassan 
1   Endoscopy Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy (Ringgold ID: RIN9268)
2   Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy (Ringgold ID: RIN437807)
,
Alessandro Repici
1   Endoscopy Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy (Ringgold ID: RIN9268)
2   Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy (Ringgold ID: RIN437807)
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Leserbrief zu:

PuraStat for gastrointestinal bleeding management: Effective approach for endoscopic prevention and rescue therapyEndosc Int Open 2025; 13(CP):
DOI: 10.1055/a-2550-6600

We thank Dr. Merola and colleagues for the thoughtful commentary about our study regarding use of PuraStat in endoscopic management and prevention of gastrointestinal bleeding. We appreciate the valuable insights shared, particularly the agreement with the potential of PuraStat for both managing active “oozing” bleeding and preventing delayed rebleeding.

Regarding the five cases of severe active bleeding discussed in our manuscript, we can provide some additional details to clarify management of these cases. Specifically:

  • Two cases of active bleeding from duodenal ulcers were treated in the first instance with epinephrine injection and hemoclip placement.

  • One case of active bleeding following a surgical colo-colonic anastomosis was treated in the first instance with hemoclip placement.

  • One case of active bleeding following a left colonic endoscopic mucosal resection was treated in the first instance with hemoclip placement.

  • One case of active bleeding that occurred during necrosectomy of a walled-off pancreatic necrosis was treated in the first instance with mechanical hemostasis.

As indicated in the manuscript, PuraStat was used as a secondary treatment in these cases, alongside other hemostatic techniques, primarily to prevent delayed rebleeding and ensure technical success. We recognize the importance of further clarifying the characteristics of the active gastrointestinal bleeding lesions most likely to benefit from PuraStat and agree that additional data would be valuable. Furthermore, we concur with the observation that prospective comparative studies will be essential for establishing the definitive role of PuraStat in bleeding control, as well as its impact on clinical outcomes such as hospitalization length, morbidity, and mortality rates.



Publikationsverlauf

Eingereicht: 18. Februar 2025

Angenommen: 24. Februar 2025

Artikel online veröffentlicht:
08. April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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Bibliographical Record
Roberta Maselli, Leonardo Da Rio, Cesare Hassan, Alessandro Repici. Response to comment on "PuraStat for gastrointestinal bleeding management: Effective approach for endoscopic prevention and rescue therapy". Endosc Int Open 2025; 13: a25506677.
DOI: 10.1055/a-2550-6677