What is EndoClot spray? An Overview of the Polysaccharide Hemostatic System

October 12, 2025 •

3 min read

EndoClot Polysaccharide Hemostatic System (PHS) has demonstrated high rates of immediate hemostasis in clinical studies for non-variceal gastrointestinal bleeding. So, what is EndoClot spray? It is a medical device that applies an absorbable, starch-based powder to bleeding sites during endoscopic procedures to accelerate the body's natural clotting cascade.

Quick Summary

EndoClot spray is an endoscopically delivered polysaccharide hemostatic powder used for non-variceal GI bleeds. It works by absorbing water from blood, concentrating clotting factors and platelets, and creating a gelled matrix to stop the bleeding. The system uses a catheter and air compressor for precise application during procedures like polypectomies or for ulcer bleeding.

Key Points

EndoClot PHS is a hemostatic powder: EndoClot spray, or PHS, is a medical device that uses absorbable, starch-derived AMP particles to control non-variceal GI bleeding.
Works by concentrating clotting factors: The AMP particles rapidly absorb water from blood, leading to a high concentration of platelets and coagulation proteins that accelerates the clotting process.
Provides a mechanical barrier: The hydrated particles form an adhesive, gel-like matrix that physically seals the bleeding area.
Bioabsorbable and safe: The plant-based AMP particles are biocompatible and naturally absorbed by the body, removing the need for retrieval.
Controlled delivery via endoscope: The system features a delivery catheter and air compressor for precise application, especially useful for hard-to-reach or diffuse bleeding sites.
Indicated for oozing bleeds: It is effective for conditions like ulcer bleeding, post-polypectomy, and EMR, but not for arterial spurting (Forrest Ia).
Adjunctive or stand-alone therapy: EndoClot can be used alone for minor bleeds or in combination with other techniques like clipping for larger, more complex hemorrhages.

What is EndoClot spray?

EndoClot spray, officially known as the EndoClot Polysaccharide Hemostatic System (PHS), is a single-use medical device employed by medical professionals to manage non-variceal gastrointestinal (GI) bleeding. The system comprises Absorbable Modified Polymer (AMP®) particles, derived from plant starch, and a delivery system designed for endoscopic application. Unlike some other hemostatic powders, EndoClot PHS utilizes a portable air compressor to deliver the powder through a catheter to the bleeding site, ensuring precise application. The components are not derived from humans or animals, making them biocompatible and non-pyrogenic.

The mechanism of action: How AMP particles achieve hemostasis

The efficacy of EndoClot PHS is based on its AMP® particles and their interaction with blood:

Rapid water absorption: The hydrophilic AMP particles quickly absorb water upon contact with blood at the bleeding site.
Concentration of clotting factors: This absorption leads to a higher local concentration of platelets, red blood cells, and natural coagulation proteins such as fibrinogen and thrombin.
Accelerated clotting: The increased concentration of these elements speeds up the body's natural clotting process, leading to rapid clot formation.
Mechanical barrier formation: The AMP particles also create a gelled, adhesive matrix that acts as a physical barrier over the wound, helping to stop bleeding.
Natural degradation: The AMP particles are bioabsorbable and broken down by digestive enzymes within a few hours.

Indications and clinical applications

EndoClot spray is suitable for various endoscopic hemostatic procedures, particularly for extensive and diffuse bleeding where other methods may be challenging. Approved uses include:

Peptic ulcer bleeding: A frequent cause of non-variceal upper GI bleeding.
Post-polypectomy or post-biopsy bleeding: Managing bleeding following the removal of polyps or tissue samples.
Bleeding during or after EMR/ESD: Controlling hemorrhage during or after endoscopic mucosal resection or endoscopic submucosal dissection.
Tumor bleeding: Addressing oozing bleeding associated with gastrointestinal tumors.

However, EndoClot PHS is not intended for Forrest Ia classification bleeding, which involves acute, arterial spurting. For such cases, initial control requires conventional endoscopic techniques or other methods, although EndoClot may be used as supplementary treatment.

Delivery system and advantages

The EndoClot delivery system is designed for effective and controlled application within the GI tract. The system components are designed for ease of use and include an air compressor, powder canister, mixing chamber, and delivery catheter.

Advantages of the system include:

Controlled delivery: The air compressor allows for consistent pressure, reducing the risk of obscured vision and enabling better visualization.
Anti-reflux design: The applicator is designed to help prevent fluids from entering and occluding the catheter.
Treatment of difficult-to-reach areas: The endoscopic delivery allows access to lesions that are challenging to treat with other instruments.

Comparison with other hemostatic powders

EndoClot PHS is one of several hemostatic powders used endoscopically. Here is a comparison with Hemospray and Nexpowder, based on available information:


Feature	EndoClot PHS	Hemospray	Nexpowder
Material	Starch-derived modified polysaccharide	Mineral powder (bentonite)	Oxidized dextran
Delivery System	External air compressor	All-in-one CO2 cartridge	All-in-one room air propellant
Delivery Pressure	Lower pressure (2.17-3.4 psi)	Higher pressure (37 psi)	Variable
Gel Formation	Yes (gelled matrix)	No	Yes (hydrogel)
Adjustability	Yes (tapping/tilting)	No	Yes
FDA Indication	NVUGIB (except Forrest Ia)	NVUGIB and LGIB	NVUGIB and LGIB
Adverse Events	Low reported adverse events	Visceral perforation and embolism reported	Low reported adverse events

Conclusion

EndoClot spray is a useful device for the endoscopic management of non-variceal GI bleeding. Its plant-based, absorbent polysaccharide particles effectively enhance the body's clotting mechanisms and provide a physical barrier. It can be used as an adjunct to conventional methods or as a primary treatment for diffuse, oozing bleeds, making it a versatile option for gastroenterologists. While generally safe and effective for its intended uses, proper technique is essential to prevent potential issues like catheter blockage. Research continues to evaluate hemostatic powders, and EndoClot PHS remains a viable choice for specific endoscopic bleeding situations, particularly those that are large or difficult to access.

More detailed technical information and comparative studies on hemostatic agents can be found in professional publications.

Frequently Asked Questions

The main component of EndoClot spray is a starch-derived, bioabsorbable hemostatic powder known as Absorbable Modified Polymer (AMP®) particles.

EndoClot spray stops bleeding by rapidly absorbing water from the blood, which concentrates platelets and clotting factors. This accelerates the natural clotting process and forms a protective, gelled matrix over the wound.

No, EndoClot PHS is indicated for non-variceal GI bleeding and is specifically not recommended for Forrest Ia classification bleeding (arterial spurting).

EndoClot is applied using a delivery catheter that is passed through the endoscope's working channel. An external air compressor propels the powder through the catheter directly onto the bleeding site.

A primary contraindication is a known allergy to starch, as the AMP particles are starch-derived. It is also not indicated for arterial spurting bleeding.

No, the AMP particles are bioabsorbable and are naturally degraded by enzymes in the GI tract. They are then eliminated from the body via stool.

Unlike Hemospray's all-in-one CO2-propelled system, EndoClot uses an external air compressor for delivery. This provides lower, more consistent pressure and allows for user-controlled application.

While serious adverse events are rare, potential risks could include inflammatory reactions, bowel rupture, and air embolism, though these are uncommon in reported clinical studies.