Hemospray™

Author: David Pechman, MD

Cook Medical received FDA approval for Hemospray on May 7, 2018.

Hemospray^TM is a proprietary mineral powder that can be administered endoscopically and promotes hemostasis. The powder, inorganic and inert, forms an adhesive layer when it comes into contact with fluid. The adhesive layer provides mechanical compression and promotes hemostasis. In addition, the powder absorbs water, increasing the concentration of platelets and clotting factors at the site of bleeding, which promotes the formation of an adherent coagulum.

Hemospray^TM is easy to administer and may be used by endoscopists with minimal experience. The device consists of a pressurized CO2 canister, a delivery catheter, and a powder reservoir. The powder is delivered in 1-2 second bursts until hemostasis is achieved. The powder and coagulated blood mixture remains in place for approximately 3 days, at which time it sloughs from the mucosa and is eliminated from the GI tract naturally.

Hemospray^TM was initially used for treating large area bleeding, such as a ruptured tumor or for rescue therapy after initial endoscopic therapy. Subsequent studies have displayed that Hemospray^TM is safe and effective in treating primary upper and lower gastrointestinal bleeding. A randomized controlled trial found that Hemospray^TM was as effective as epinephrine injection and clipping as the primary endoscopic treatment for patients with non-variceal acute upper gastrointestinal bleeding¹.

Hemospray^TM is indicated for use in cases of upper or lower gastrointestinal bleeding, especially when advanced endoscopic equipment or expertise is not available.

Due to concerns for gas embolism, the manufacturer listed the presence of varices as a contraindication to the use of Hemospray^TM. Several studies, however, have shown that Hemospray is effective and safe in the treatment of acute gastrointestinal variceal bleeding^2,3.

 

¹ Ibrahim M, El-Mikkawy A, Abdalla H, Mostafa I, Devière J. Management of acute variceal bleeding using hemostatic powder. United European Gastroenterol J. 2015

² Holster IL, Poley JW, Kuipers EJ, Tjwa ET. Controlling gastric variceal bleeding with endoscopically applied hemostatic powder (Hemospray™) J Hepatol. 2012;57:1397–1398

³ Stanley AJ, Smith LA, Morris AJ. Use of hemostatic powder (Hemospray) in the management of refractory gastric variceal hemorrhage. Endoscopy 2013; 45 Suppl 2: E86-E87.