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Emergency Endoscopic Hemostasis for Gastrointestinal Bleeding Using a Self-Assembling Peptide: A Case Series

Authors :
Takashi Murakami
Eiji Kamba
Keiichi Haga
Yoichi Akazawa
Hiroya Ueyama
Tomoyoshi Shibuya
Mariko Hojo
Akihito Nagahara
Source :
Medicina, Vol 59, Iss 5, p 931 (2023)
Publication Year :
2023
Publisher :
MDPI AG, 2023.

Abstract

Background and Objectives: A novel synthetic self-assembling peptide, PuraStat, has been introduced as a hemostatic agent. This case series aimed to evaluate the clinical efficacy of PuraStat for gastrointestinal bleeding during emergency endoscopy. Cases: Twenty-five patients with gastrointestinal bleeding who had undergone emergency endoscopy with PuraStat between August 2021 and December 2022 were retrospectively examined. Six patients were receiving antithrombotic agents, and ten patients with refractory gastrointestinal bleeding had undergone at least one endoscopic hemostatic procedure. The breakdown of bleeding was gastroduodenal ulcer/erosion in 12 cases, bleeding after gastroduodenal or colorectal endoscopic resection in 4 cases, rectal ulcer in 2 cases, postoperative anastomotic ulcer in 2 cases, and gastric cancer, diffuse antral vascular ectasia, small intestinal ulcer, colonic diverticular bleeding, and radiation proctitis in each case. The method of hemostasis was only PuraStat application in six cases, and hemostasis in combination with high-frequency hemostatic forceps, hemostatic clip, argon plasma coagulation, and hemostatic agents (i.e., thrombin) in the remaining cases. Rebleeding was observed in three cases. Hemostatic efficiency was observed in 23 cases (92%). Conclusions: PuraStat has the expected hemostatic effect on gastrointestinal bleeding during emergency endoscopy. The use of PuraStat should be considered in emergency endoscopic hemostasis of gastrointestinal bleeding.

Details

Language :
English
ISSN :
16489144 and 1010660X
Volume :
59
Issue :
5
Database :
Directory of Open Access Journals
Journal :
Medicina
Publication Type :
Academic Journal
Accession number :
edsdoj.469ab01ec97b4c35a2f5a127d5bdeff9
Document Type :
article
Full Text :
https://doi.org/10.3390/medicina59050931