Haemostasis and prevention of bleeding related to ER: The role of a novel self-assembling peptide

Abstract

Background: Endoscopic resection is now commonly used for removal of early gastrointestinal lesions. However, the risk of the procedure may be heightened by intraprocedural or delayed bleeding. A novel, self-assembling peptide (PuraStat®) was recently licensed for use as a haemostat.

Objective: The aim of this study was to assess the efficacy and safety of this haemostat when used to control intraprocedural bleeding or to prevent delayed bleeding in endoscopic resection.

Methods: PuraStat® was used on 100 patients undergoing endoscopic resection in a tertiary referral centre. The efficacy, safety, feasibility of use and delayed bleeding rates were measured.

Results: Forty-eight oesophageal, 31 colorectal, 11 gastric and 10 duodenal procedures were included. The mean lesion size was 3.7 cm and 30% of the patients were on antithrombotic therapy. Intraprocedural bleeding occurred in 64%. PuraStat® was an effective haemostat in 75% of these cases. Only a small amount was required for haemostasis (mean = 1.76 ml) and it took on average 69.5 seconds to stop a bleed. The delayed bleeding rate was 3%.

Conclusions: PuraStat® is an effective haemostat for use in controlling bleeds during endoscopic resection. It is safe, easy to use and did not interfere with the procedure.

Keywords: Delayed bleeding; endoscopic mucosal resection; endoscopic submucosal dissection; haemostasis; self-assembling peptide.

Figures

Figure 1.

Building blocks of PuraStat®. (Figure reproduced with permission from 3D-Matrix Ltd.)

Figure 2.

Application of PuraStat® through the delivery catheter.

Figure 3.

Transparent nature of PuraStat®.