Letter to the Editor
Copyright ©The Author(s) 2025.
World J Gastrointest Endosc. May 16, 2025; 17(5): 107183
Published online May 16, 2025. doi: 10.4253/wjge.v17.i5.107183
Table 1 Recent studies on the use of PuraStat® in digestive endoscopy as a haemostatic agent for gastrointestinal bleeding
Ref.
Study design
n
Treated lesion(s)
Efficacy
Oza et al[9], 2024Case series10Anastomotic ulcers90%1
Higashino et al[10], 2024Case report1Mallory-Weiss syndrome100%2
Yamaguchi et al[11], 2024Retrospective25Colonic diverticular bleeding100%3
Maselli et al[12], 2024Retrospective91Various (active bleeding)98.9%
Yoshida et al[13], 2024Retrospective122Perioperative colorectal cold snare polypectomy under anticoagulant92.6%
Gomi et al[14], 2024Retrospective101Post-endoscopic submucosal dissection ulcer prevention94.1%4
Murakami et al[15], 2023Case series25Various (active bleeding)92%5
Okumura et al[16], 2023Case report1Endoscopic submucosal dissection bleeding100%
Nakahara et al[17], 2023Case report1Fistula bleeding (endoscopic ultrasound-guided hepaticogastrostomy)100%
Kubo et al[18], 2023Case series6Various (active bleeding)100%
Ishida et al[19], 2022Case series6Sphincterotomy-related hemorrhage100%
Gagliardi et al[20], 2021Case report1Solitary rectal ulcer syndrome100%6
1In this series, only 4 out of 10 patients had active gastrointestinal bleeding at the level of the anastomotic ulcer. Therefore, the primary focus was on assessing the potential of PuraStat® to promote ulcer healing and improve the patients' clinical condition. Over a three-month follow-up period, ulcer healing was observed, with clinical improvement in 9 out of 10 patients.
2The case was initially treated with mechanical haemostasias (clipping) without success.
3Two patients were treated with monotherapy, while the majority (23 patients) received combination therapy—13 out of 23 with endoscopic band ligation and 10 out of 23 with mechanical haemostasias using clipping.
4The efficacy rate was calculated considering that 6 out of 101 patients (5.9%) developed post-endoscopic submucosal dissection bleeding among those who had been preventively treated with PuraStat® after gastric endoscopic submucosal dissection.
5PuraStat® was used as monotherapy in 6 out of 25 cases.
6Although the patient had anaemia, there was no overt bleeding as the primary clinical manifestation.