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Case Reports
. 2022 Nov 10;3(1):e183.
doi: 10.1002/deo2.183. eCollection 2023 Apr.

A case of gastric antral vascular ectasia in which PuraStat, a novel self-assembling peptide hemostatic hydrogel, was effective

Yoshitsugu Misumi  1 , Miharu Takeuchi  1 , Maiko Kishino  1 , Yoshimichi Kudo  2 , Kouichi Nonaka  1
Affiliations
Case Reports

A case of gastric antral vascular ectasia in which PuraStat, a novel self-assembling peptide hemostatic hydrogel, was effective

Yoshitsugu Misumi et al. DEN Open. .

Abstract

Gastric antral vascular ectasia (GAVE) is a gastric hemorrhagic disease associated with chronic liver disease. Argon plasma coagulation is widely used to control gastrointestinal bleeding due to GAVE. Although argon plasma coagulation is a relatively safe endoscopic procedure, it is not suitable in some cases, such as in patients with pacemakers. We report a case of GAVE in which PuraStat, a novel self-assembling peptide hemostatic hydrogel, was effective. The patient was a 55-year-old man who had undergone Fontan surgery for tricuspid regurgitation more than 20 years prior. He developed hepatic cirrhosis as a complication following Fontan surgery. During upper gastrointestinal endoscopy to examine the cause of the progression of anemia and black stool, bleeding from GAVE was observed; PuraStat was applied to stop the bleeding. Postoperatively, the black stool disappeared, and his hemoglobin levels improved. Upper gastrointestinal endoscopy was performed 13 days after the surgery; the density of the capillaries in the antrum was significantly decreased, and a clear trend toward disappearance was observed. Therefore, the application of PuraStat may be useful in the treatment of GAVE.

Keywords: PuraStat; endoscopic hemostasis; gastric antral vascular ectasia; gastric hemorrhage; self‐assembling peptide hydrogel.

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Conflict of interest statement

None.

Figures

FIGURE 1
FIGURE 1
(a) Radial linear telangiectasia in the antrum, typical of watermelon stomach. (b) Clot adhesion and oozing were observed immediately after insertion.
FIGURE 2
FIGURE 2
(a) Dedicated catheter for PuraStat. (b) A catheter was used to create a small gel bulge on top of the telangiectasia.
FIGURE 3
FIGURE 3
Comparison of esophagogastroduodenoscopy findings on day 1 (a) and day 13 (b). A clear decrease in the density of telangiectasia and the disappearance of redness was observed.
See this image and copyright information in PMC

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