EFFICACY OF PURASTAT IN UPPER AND LOWER ACUTE GASTROINTESTINAL BLEEDING: A DUAL CASE SERIES EXPERIENCE

Aims:

Gastrointestinal (GI) bleeding is a common cause for hospitalization, resulting in significant mortality and morbidity. Innovative topical hemostatic modalities have been developed for endoscopic use. Our aim is to demostrate the efficacy, feasibility and safety of Purastat to control GI bleedings. Puramatrix is a synthetic, bioresorbable material used to produce Purastat, created to control venous/arteriolar bleedings, It's easy, quick and trasparent allowing to continue the procedure/to use other haemostatic therapies.

Methods:

We report a case series of 25 patients (16 male, 9 women, median age 73 years) recovered to two endoscopy units (Garbagnate Milanese and Monza) for acute GI bleeding after failure of other hemostatic strategies (injection/clipping/thermal coagulation). 14/25 patients presented a lower GI haemorrhage from an oozing site after mucosectomy for non polypoid colon adenomas in different sites of the colon (8 pts from the right colon) 3 patients showed melena for duodenal bleeding from bulbar kissing ulcers, 3 patients with melena and anemization after duodenal mucosectomy for a laterally spreading tumor of the second part of the duodenum,3 patients had emathemesis after Vater papilla's sphincterotomy, 1 patient showed progressive anemization for bleeding inside a pseudocyst after endoscopy ultrasound guided drainage and 1 patient presented with a massive rectal bleeding after a prostatic biopsy.

Results:

In all these patients, we tried to achieve a successfull hemostasis first of all using an adrenaline injection and subsequently with clipping and/or argon plasma coagulator application without success. Finally we used a strate of Purastat applying 3 ml of gel, with a successfull, stable hemostasis and a complete patients recovery in few days after the procedure, no pain and haemodinamical stability. No need to surgery or radiological haemostatic procedures.

Conclusions:

Purastat is a new, safe and feasible hemostatic device capable to control different types of GI haemorrhages even if the arteriolar massive ones.