Azer SA. Hemostasis: Role of PuraStat® in the prevention and management of gastrointestinal bleeding. World J Gastrointest Endosc 2025; 17(7): 106725 [DOI: 10.4253/wjge.v17.i7.106725]
Corresponding Author of This Article
Samy A Azer, Professor, Department of Medical Education and Medicine, College of Medicine at King Saud University, PO Box 2925, Riyadh 11461, Riyadh, Saudi Arabia. azer2000@optusnet.com.au
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Jul 16, 2025; 17(7): 106725 Published online Jul 16, 2025. doi: 10.4253/wjge.v17.i7.106725
Hemostasis: Role of PuraStat® in the prevention and management of gastrointestinal bleeding
Samy A Azer
Samy A Azer, Department of Medical Education and Medicine, College of Medicine at King Saud University, Riyadh 11461, Riyadh, Saudi Arabia
Author contributions: Azer SA has searched the literature on several databases, top journals in gastroenterology and others, extracted papers related to the topic, read and organised the outcomes from the literature, studied the paper to write the editorial on, drafted the first part of the editorial, revised and amended based on the literature and research evidence, and then created the final manuscript after several revisions and changes.
Conflict-of-interest statement: The author has no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Samy A Azer, Professor, Department of Medical Education and Medicine, College of Medicine at King Saud University, PO Box 2925, Riyadh 11461, Riyadh, Saudi Arabia. azer2000@optusnet.com.au
Received: March 6, 2025 Revised: May 4, 2025 Accepted: June 24, 2025 Published online: July 16, 2025 Processing time: 125 Days and 23 Hours
Abstract
The management of gastrointestinal (GI) bleeding patients during endoscopy remains a challenge. Hemorrhage is still one of the significant causes of morbidity and even death. Several therapeutic options have been used over the years depending on the extent, site and cause of bleeding. These include thermal therapy, injection therapy, and mechanical methods of hemostasis (e.g., endoscopic clips and ligation bands). Patients with refractory bleeding, high-risk ulcer lesions, malignant disease, antiplatelet medications, and chronic kidney disease are at increased risk of upper and lower GI bleeding (LGIB). In this editorial, I commented on the paper by Ballester et al. Their work aimed at evaluating PuraStat® (TDM-621), a novel hemostatic agent, particularly its efficacy, applications, feasibility, and safety in treating GI bleeding lesions. The authors concluded that PuraStat® is an effective therapy for GI bleeding and is usually easy to use. Although the authors recommended its consideration as a frontline therapy in the future, they did not explore the clinical and GI uses of PuraStat®. This editorial focuses on the pharmacology of PuraStat® and how it differs from Hemospray® (TC-325) (hemostatic powder). It also explores the current experience of using PuraStat® in upper and LGIB, its uses and safety, and the need for further research to fully understand its potential.
Core Tip: Patients experiencing upper or lower gastrointestinal (GI) bleeding, whether due to a medical condition or an endoscopic procedure, should be managed immediately using a simple, effective and safe agent or technique. PuraStat® (TDM-621) is a novel transparent, self-assembled hydro-peptide gel with a hemostatic effect that has been used in endoscopic and surgical procedures, particularly for preventing and managing GI bleeding. It is unique in its ability to adhere to the bleeding site, forming a protective barrier and promoting rapid hemostasis. It has been proven effective and safe compared to currently used agents.
