Copyright
©The Author(s) 2025.
World J Gastrointest Endosc. Jul 16, 2025; 17(7): 106725
Published online Jul 16, 2025. doi: 10.4253/wjge.v17.i7.106725
Published online Jul 16, 2025. doi: 10.4253/wjge.v17.i7.106725
Table 2 summarises the pharmacological and clinical aspects of PuraStat® and hemostatic powder [Hemospray® (TC-325)]
Item | PuraStat® (3-D Matrix-621) | Hemostatic powder spray [Hemospray® (TC-325)] | Ref. |
Structure and active component | A synthetic hydrogel peptide. It is a 25% RADA16, a linear oligopeptide containing 16 amino acids as repeated 4-amino acids sequence containing R (positively charged arginine), A (hydrophobic alanine), and D (negatively charged aspartic acid) residues | A mineral-based hemostatic powder. It is calcium-based or silicate minerals | Sankar et al[41] |
Human and animal proteins | N/A | N/A | |
Mechanisms of action | It forms an extracellular scaffold matrix when activated by the change in potential of hydrogen that occurs upon contact with blood | The granules once exposed to blood or tissue fluids; absorbs all the water causing its swelling and adherence to the bleeding sites | Uraoka et al[42], Sung et al[52] |
Clinical uses | Used for upper and lower GI bleeding. Also, bleeding after EMR or esophageal and colonic submucosal dissection, and other surgical procedures | Primarily used for non-variceal GI bleeding | Stenson et al[47], Friedland et al[48], Wong et al[49], Gangner et al[50] |
Application in endoscopic procedures | Applied via a catheter through an endoscope | The powder is delivered via a spray mechanism using inert gas e.g., nitrogen | |
Biocompatibility | Nontoxic | Biocompatible and nontoxic | |
Degradation | Is absorbable. It does not require removal after application | Is absorbable. It does not require removal after application | |
Immunogenicity | Nonimmunogenic | Nonimmunogenic | |
Clinical safety | Quite safe | Quite safe, and it washes out at 12 hours to 24 hours | |
Limitations and adverse effects | Less effective in massive and large bleeding areas. In a multicenter prophylactic randomised controlled trial testing its hemostatic prophylactic effect after EMR (large lesions in the duodenum and colorectum, no reduction in the rate of delayed bleeding observed) | Any type of moisture in the area will result in amalgamation of the powder which may block the delivery catheter. Not suitable for variceal bleeding | Drews et al[59] |
- Citation: Azer SA. Hemostasis: Role of PuraStat® in the prevention and management of gastrointestinal bleeding. World J Gastrointest Endosc 2025; 17(7): 106725
- URL: https://www.wjgnet.com/1948-5190/full/v17/i7/106725.htm
- DOI: https://dx.doi.org/10.4253/wjge.v17.i7.106725