Aims PuraStat is a novel haemostatic agent without the risk of thermal injury, perforation
or loss of mucosal views associated with other treatments such as heat therapy, clips
or haemostatic powders. Our aim was to evaluate the efficacy of PuraStat in the prevention
and treatment of gastro-intestinal bleeding.
Methods This is a prospective analysis of PuraStat use in the UK, with 6 tertiary referral
centres open to recruitment. Data was collected on procedure & lesion details, haemostasis
management and complications for endoscopies where PuraStat was used.
Results 226 procedures were included across 3 indications: 198 high risk resection, 6 upper
gastro-intestinal bleeding (UGIB) and 22 radiation proctopathy. PuraStat was used
for immediate haemostasis in 100 bleeding episodes, of which 92 were as primary agent
and 8 as secondary agent (after failure of alternative initial therapy) and for prevention
of delayed bleeding in 177 cases (see [Table 1]). PuraStat was additionally used in 22 radiation proctopathy cases, as sole therapy
in 14 and secondary therapy in 8, with improvement in patient reported symptom score
and haemoglobin. The average volume of Purastat used across all indications was 0.43mls
for haemostasis and 2.33mls for prevention of delayed bleeding. No PuraStat related
complications were reported.
Tab. 1
Haemostatic efficacy of PuraStat
|
Indication
|
Procedures n=204 (n)
|
Immediate haemostasis n=100 (n, %)
|
Prevention of delayed bleeding n=177 (n, %)
|
|
High risk resection
|
198
|
90/98 (91.8%)
|
169/173 (97.7%)
|
|
UGIB
|
6
|
2/2 (100%)
|
4/4 (100%)
|
|
Overall
|
204
|
92/100 (92.0%)
|
173/177 (97.7%)
|
Conclusions Our data shows PuraStat is safe and effective for a range of indications, with most
use within high risk resections. It shows high efficacy in both immediate haemostasis
and prevention of delayed bleeding. We believe PuraStat is a promising new agent in
the prevention and management of gastro-intestinal bleeding.
