Tu1020 OUTCOMES FROM THE UK PURASTAT REGISTRY – A MULTICENTRE PROSPECTIVE OBSERVATIONAL STUDY TO EVALUATE THE ROLE OF PURASTAT IN THE MANAGEMENT OF GASTROINTESTINAL BLEEDING (POPS)

PuraStat is a novel haemostatic agent without the risk of thermal injury, perforation or loss of mucosal views associated with other treatments such as heat therapy, clips or haemostatic powders. The aim of our study was to evaluate the efficacy of PuraStat as a haemostatic agent when used in the prevention and treatment of gastro-intestinal bleeding. In 2019, the UK PuraStat registry expanded from a single site to 6 tertiary referral centres across the UK. Prospective data was collected on baseline demographics, procedural & haemostatic details and complication rates for endoscopies where PuraStat was used and uploaded to a national web-based database. 141 procedures across 4 endoscopic indications were included as shown in Table 1. PuraStat was used for immediate haemostasis in 2 upper gastro-intestinal bleeds, in both cases achieving haemostasis after failure of primary alternative therapy. In radiation proctopathy, it was used as a sole agent for 14 cases and as secondary therapy for 8 cases, with an average 4.8g/L increase in Haemoglobin and 2.6 point reduction in patient reported symptom score. 33 high risk endoscopic therapies used PuraStat for intraprocedural bleeding, with a total of 45 individual bleeding episodes. PuraStat was used for immediate haemostasis in 36 of these episodes (32 as primary therapy and 4 as secondary therapy after failed alternative first line therapy), achieving haemostasis in 23/36 cases (91.7%). Both delayed iatrogenic bleeds were successfully treated with PuraStat as sole therapy. The delayed bleeding rate was 2.04% within the high risk therapy category and 1.64% in the whole 141 procedure cohort. The average volume of Purastat used was 0.43mls for haemostasis and 2.33mls for prevention of delayed bleeding. No complications related to PuraStat use were reported. Our data suggests PuraStat to be safe and effective for a range of indications, with most experience within high risk therapy. It is most commonly used for prevention of delayed bleeding at present, with a low associated delayed bleeding risk; however it also shows high efficacy in immediate haemostasis. We believe PuraStat to be a promising new agent in the prevention and management of gastro-intestinal bleeding.