Post written by Daisuke Yamaguchi, MD, PhD, from the Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, and the Department of Gastroenterology, Ureshino Medical Center, Ureshino, Japan.

This study evaluated the efficacy and safety of using a self-assembling peptide solution (PuraStat; 3-D Matrix, Tokyo, Japan) for endoscopic hemostasis in patients with colonic diverticular bleeding, particularly those presenting with stigmata of recent hemorrhage. The study also compared outcomes of PuraStat monotherapy or its combination with endoscopic band ligation or clipping with those of conventional methods without PuraStat.

Colonic diverticular bleeding is a major cause of lower GI bleeding, and its recurrence after conventional endoscopic hemostasis remains a significant challenge. PuraStat, with its novel self-assembling hydrogel mechanism, was hypothesized to enhance hemostasis and reduce recurrence. However, its effectiveness for colonic diverticular bleeding had not been systematically evaluated in a multicenter setting, to our knowledge.

We enrolled 25 patients who underwent endoscopic hemostasis using PuraStat and compared them with a historical cohort of 110 patients treated without it. The endoscopic hemostasis success rate was 100% in the PuraStat group, and the 30-day recurrent bleeding rate was significantly lower (4.0% vs 20.9%, P = .047). Multivariate analysis identified PuraStat as the only independent factor associated with reduced recurrence (OR, .11; 95% CI, .01-.95; P = .045). These findings suggest that PuraStat can be safely integrated into standard hemostatic techniques and may help reduce rebleeding.

A, Bleeding from an ascending colonic diverticulum discovered during colonoscopy. B, Confirmation of active bleeding from the diverticulum in red dichromatic imaging mode. C, PuraStat was injected into the diverticulum with a dispersal tube. D, After the injection, complete hemostasis was achieved using endoscopic band ligation in red dichromatic imaging mode.

Read the full article online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.