Editorial
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
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 componentA 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) residuesA mineral-based hemostatic powder. It is calcium-based or silicate mineralsSankar et al[41]
Human and animal proteinsN/AN/A
Mechanisms of actionIt forms an extracellular scaffold matrix when activated by the change in potential of hydrogen that occurs upon contact with bloodThe granules once exposed to blood or tissue fluids; absorbs all the water causing its swelling and adherence to the bleeding sitesUraoka et al[42], Sung et al[52]
Clinical usesUsed for upper and lower GI bleeding. Also, bleeding after EMR or esophageal and colonic submucosal dissection, and other surgical proceduresPrimarily used for non-variceal GI bleedingStenson et al[47], Friedland et al[48], Wong et al[49], Gangner et al[50]
Application in endoscopic proceduresApplied via a catheter through an endoscopeThe powder is delivered via a spray mechanism using inert gas e.g., nitrogen
BiocompatibilityNontoxicBiocompatible and nontoxic
DegradationIs absorbable. It does not require removal after applicationIs absorbable. It does not require removal after application
ImmunogenicityNonimmunogenicNonimmunogenic
Clinical safetyQuite safeQuite safe, and it washes out at 12 hours to 24 hours
Limitations and adverse effectsLess 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 bleedingDrews et al[59]