Hemostatic spray powder TC-325 in the primary endoscopic treatment of peptic ulcer-related bleeding: multicenter international registry

Abstract

Introduction Upper gastrointestinal bleeding (UGIB) is a leading cause of morbidity and associated with a 2-17% mortality in the United Kingdom (UK) and USA [1]. Peptic ulcers account for 50% of UGIB’s. Endoscopic intervention in a timely manner can improve outcomes. Hemospray (Cook Medical, North Carolina, USA) is an endoscopic haemostatic powder for GI bleeding. This multicentre registry was created to collect data prospectively on the immediate Endoscopic haemostasis of GI bleeding in patients with peptic ulcer disease when Hemospray is applied as endoscopic monotherapy, dual therapy or rescue therapy. Methods Data were collected prospectively (January 2016 – March 2019) from 14 centres in the (UK, France, Germany and the USA). The application of Hemospray was decided upon at the endoscopist’s discretion. Results 202 patients with UGIB secondary to peptic ulcers were recruited. Immediate haemostasis was achieved in 178/202 (88%) of patients, 26/154 (17%) had a re-bleed, 21/175 (12%) died within 7 days, 38/175 (22%) died within 30 days (all-cause mortality). Hemospray combination therapy with other endoscopic modalities had an associated lower 30-day mortality (16%, P <0.05) relative to Hemospray monotherapy or rescue therapy. There were high immediate haemostasis rates across all PUD Forrest classifications. Conclusions This is the largest case series of outcomes of peptic ulcer bleeds treated with Hemospray. There were high immediate haemostasis rates with Hemospray in oesophageal and peptic ulcer bleeds.

Endoscopic Cyanoacrylate Injection Treatment for Refractory High-risk Peptic Ulcer Bleeding by Conventional Endoscopic Therapy

“…29 In order to further improve the clinical outcomes of patients with high-risk peptic ulcer bleeding, some new endoscopic hemostatic modalities, including over-the-scope clips (OTSC) and hemospray, have been developed. A recently published study showed that in Hemospray-treated 202 patients with peptic ulcer bleeding, immediate hemostasis rate was 88% (178/202), 17% (26/154) experienced rebleeding, and overall all-cause mortality was 34% (59/175) within 30 days 30 . A previous study showed that successful hemostasis rate of OTSC treatment was 77.8% in refractory peptic ulcer bleeding with big size 31 .…”

Obere nicht variköse gastrointestinale Blutung

“…B. [13]). Der Autor sieht einen Hauptnutzen vor allem in der Anwendung ▪ bei der diffusen Tumorblutung, da hier ein breitflächiges Nichtkontaktverfahren vorteilhaft ist [14], sowie ▪ bei aufgrund der Lokalisation (und ggf.…”

Endoscopic hemostasis for nonvariceal upper gastrointestinal bleeding

“…OTSC has traditionally been used to close perforations and fistulas in the gastrointestinal tract; however, its hemostatic application has been reported in European countries and Japan. Furthermore, the application of a hemostatic spray has been reported in a prospective multicenter study conducted mainly in Europe and the United States 19 . It was found to have a high initial hemostatic rate and contributed to a decrease in mortality within 30 days.…”

“…Furthermore, the application of a hemostatic spray has been reported in a prospective multicenter study conducted mainly in Europe and the United States. 19 It was found to have a high initial hemostatic rate and contributed to a decrease in mortality within 30 days.…”