Role of hemostatic powders in the endoscopic management of gastrointestinal bleeding

Table 1 Hemostatic powders currently available

Name	Composition	Mechanism of action	Regulatory clearance
Hemospray™	Mineral	Absorption of water	Approved in Europe and Canada1
		Concentration of platelets and clotting factors	Under evaluation in United States
		Mechanical tamponade
EndoClot™ PHS	Absorbable hemostatic polysaccharides	Absorption of water	Approved in Turkey, Europe, Malaysia and Australia
		Concentration of platelets and clotting factors
		Mechanical tamponade
Ankaferd® Blood Stopper	Mixture of plants	Encapsulated protein network that provides focal points for erythrocyte aggregation	Approved in Turkey

¹For non-variceal upper gastrointestinal bleeding.

Table 2 Possible indications for the use of hemostatic powders

Primary hemostatic method	Adjuvant therapy
Lesions with a difficult endoscopic access	Failure of conventional methods
Less experienced examiner
Malignant gastrointestinal bleeding
Massive bleeding as a mean to achieve an initial hemostasis