TBA (22W170)
Role Of A Novel Peptide-based Haemostatic Agent (PuraStat®) In Early Gastrointestinal Bleeding Management: A Single Centre Experience.
Author(s)
C. Costigan, R. Ballester-Clau, S. Sengupta, F. O´Hara and D. McNamara.
Department(s)/Institutions
Dept of Gastroenterology, Tallaght University Hospital, Dublin
Introduction
PuraStat® has been shown to be effective in controlling inta-procedural and delayed postpolypectomy bleeding. Its role as a haemostatic agent in all bleeding indications remains to be clarified.
Aims/Background
To assess the efficacy, feasibility and safety of PuraStat® in an open-label selected bleeding cohort.
Method
A retrospective analysis of all endoscopic uses of PuraStat® was performed. Demographics, endoscopic data, haemostasis rates, endoscopist assessment and short & medium-term outcomes from endoscopy database and EPR were collected.
Results
42 cases requiring monotherapy or adjuvant therapy with PuraStat were identified over 18 months. 17(40.5%) were female. The mean age 65.9 years. The most common procedure was Gastroscopy in 33 cases(78.6%), Colonoscopy 6(14.3%), ERCP 2(4.8 %) and DAE 1(2.4%) The most common sources included peptic ulcer in 20 cases(47.6%), postpolypectomy 6(14.3%), oesophageal origin 4(9.5%), neoplasia 3(7.1%). Initial haemostasis was achieved in all cases and no intra-pocedural complications were documented. 3(7.1%) patients re-bled (1 ischaemic oesophageal ulcer, 1 deep D3/4 ulcer, 1 ampulloma). 3 patients died within the first 30 days of therapy. Use of PuraStat® was reported “Very Easy” or “Easy” in all but 1 case(position & gravity) Where available, documented rationale for applying PuraStat® included difficult position or fibrosis (11/25 cases), and as rescue therapy following standard of care (4/25 cases).
Conclusions
In our cohort, PuraStat® was a safe and effective first line and rescue therapy for a variety of bleeding aetiologies, and considered easy to use in the majority. Its role as a front line agent should be considered in the future.
