Efficacy of hemostatic gel for perioperative bleeding and prevention of delayed bleeding of cold snare polypectomy under anticoagulant

Background and Aim A hemostatic gel, PuraStat (3‐D Matrix, Tokyo, Japan), is used for various gastrointestinal hemostasis. In this study, we analyzed the efficacy of PuraStat for perioperative bleeding (POB) and prevention of delayed bleeding (DB) to colorectal cold snare polypectomy (CSP) with cont...

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Published in:JGH open 2024-01, Vol.8 (1), p.e13029-n/a
Main Authors: Yoshida, Naohisa, Dohi, Osamu, Inagaki, Yoshikazu, Tomita, Yuri, Hashimoto, Hikaru, Kobayashi, Reo, Inoue, Ken, Hirose, Ryohei, Morimoto, Yasutaka, Inada, Yutaka, Murakami, Takaaki, Itoh, Yoshito
Format: Article
Language:English
Subjects:
Anticoagulants
Cardiac arrhythmia
Cardiovascular disease
Catheters
Cold
cold snare polypectomy
Colonoscopy
colorectal polyps
delayed bleeding
Endoscopy
Esophagus
Hydrogels
Morphology
Original
perioperative bleeding
Polyps
Prevention
Risk factors
Thromboembolism
Tumors
Ulcers
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Summary:Background and Aim A hemostatic gel, PuraStat (3‐D Matrix, Tokyo, Japan), is used for various gastrointestinal hemostasis. In this study, we analyzed the efficacy of PuraStat for perioperative bleeding (POB) and prevention of delayed bleeding (DB) to colorectal cold snare polypectomy (CSP) with continuous anticoagulant. Methods This was a single‐center, retrospective study. Subjects were lesions of 2–9 mm under continuous anticoagulant from 2021 to 2023 and treated with PuraStat for POB. The definition of POB was bleeding which did not stop spontaneously by 1.0–1.5 min after resection and needed hemostasis. Successful hemostasis was defined as cessation of bleeding within 1.0–1.5 min after spraying PuraStat and the rate of it and risk factors of POB were analyzed. For comparison, cases receiving previous CSP without PuraStat were extracted from all cases with CSP (2018‐2021), and POB and DB rate (DBR) were analyzed after propensity score matching. Results One hundred twenty‐two lesions (91: direct oral anticoagulant (DOAC), 31: warfarin) with anticoagulant were analyzed and the rate of successful hemostasis with PuraStat was 92.6% (DOAC/warfarin: 93.4%/80.6%, P = 0.01). The rate of DB was 0.0%. Multivariate analysis showed that significant risk factors about unsuccessful hemostasis for POB with PuraStat were lesion size 8–9 mm (P 
ISSN:2397-9070
2397-9070
DOI:10.1002/jgh3.13029