Endoscopic hemostatic powder spray: Current evidence and clinical applications

Table 2 Summary of reported hemostasis and rebleeding rates of hemostatic powders by clinical scenario

	Indication	Highest hemostasis rate, %	Lowest rebleeding rate, %	Reported study designs	Remarks
TC-325 (Hemospray®)	NVUGIB	100	2.1	Prospective[22,26], retrospective[19,20,21,34]	Hemostatic rate varies slightly across studies but remains generally high
	Variceal Bleeding	100	0	Prospective[15,16,18,48], case[13,17]	Demonstrates high hemostatic success rates as bridging therapy in emergency settings
	Peptic Ulcer Bleeding	95	15	Prospective[14,23,24], retrospective[25]	Not recommended as monotherapy, particularly to be avoided in Forrest Ia lesions
	Tumor Bleeding	100	2.1	Prospective[32,33], retrospective[28,35], case[29,30,43,44,46]	Highly effective for tumor oozing in palliative or bridging therapy, but limited sample size
	GIB in children	100	12	Prospective[38], retrospective[39], case[40]	Just performs well in small-scale studies but requires confirmation in larger trials
	Post-procedural Bleeding	100	0	Case[31,41,42,45]	Performs well in small-scale studies, requires confirmation in larger trials
	Diverticular bleeding	100	0	Retrospective[47]	Limited evidence but effective in selected cases
EndoClot®	GIB	86	11.4	Prospective[50,52], retrospective[53]	Hemostatic rate is stable
	Post-EMR Bleeding	78	4.7	Prospective[55]	Applicable in both prophylaxis and treatment of procedure-related bleeding
	Diverticular bleeding	100	0	Case[56]	Performs well in small-scale studies but requires confirmation in larger trials
Ankaferd Blood Stopper®	GIB	100	0	Prospective[61], retrospective[62], case[65]	Existing studies involve small sample sizes, although reported hemostatic rates are high
UI-EWD (NexPowder™)	NVUGIB	97	3.7	Prospective[71], retrospective[70,74]	High immediate hemostasis in a large Korean cohort
	LGIB	100	5.5	Retrospective[72,73]	Immediate hemostasis is high, but evidence is limited
	Tumor Bleeding	100	26.1	Retrospective[68], case[69]	Limited sample size but reported hemostatic rates are high
CEGP-003 (CG-Bio)	UGIB	100	8.6	Prospective[75,76]	Existing studies have relatively small sample sizes, but reported hemostasis rates are high
Polysaccharide Hemostatic Powder	GIB	100	0	Prospective[81,82,83]	Higher hemostatic rates achieved in Forrest IIa lesions
	Post-procedural Bleeding	100	0	Prospective[84,87,88,89], retrospective[86], case[80]	Well-documented and highly effective for post-ESD/EST bleeding

EMR: Endoscopic mucosal resection; ESD: Endoscopic submucosal dissection; EST: Endoscopic sphincterotomy; GIB: Gastrointestinal bleeding; LGIB: Lower gastrointestinal bleeding; NVUGIB: Non-variceal upper gastrointestinal bleeding; UGIB: Upper gastrointestinal bleeding.