Safety and Efficacy of Hemospray<sup>®</sup>in Upper Gastrointestinal Bleeding

Yau, Alan Hoi Lun; Ou, George; Galorport, Cherry; Amar, Jack; Bressler, Brian; Donnellan, Fergal; Ko, Hin Hin; Lam, Eric; Enns, Robert

doi:10.1155/2014/759436

Cited by 88 publications

(89 citation statements)

References 18 publications

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“…Hemospray (Cook Medical, USA), a novel inorganic powder, has recently been approved in Canada for the management of nonvariceal upper digestive bleeding [48,49]. It achieves hemostasis by adhering to the bleeding site, which leads to mechanical tamponade and by promoting thrombus formation [50].…”

Section: Discussionmentioning

confidence: 99%

Clinical Features, Endoscopic Management and Outcome of Patients with Non-variceal Upper Digestive Bleeding by Dieulafoy Lesion

Goldiş¹,

Lupușoru²,

Lazăr³

2017

Biol Med

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Abstract:Aim and background: Dieulafoy lesion (DL) represents a rare, but important cause of major upper digestive bleeding, especially in elders. The aim of the study consists in identifying the clinico-biological and endoscopic features and the outcome of these patients. Methods:We retrospectively evaluated the patients admitted with non-variceal upper digestive bleeding (UDB) in the Department of Gastroenterology, of the Emergency County Hospital Timisoara, from 2003 to 2014. Out of the total number of cases we selected the patients with endoscopic diagnosis of Dieulafoy lesion. In these patients we analyzed the demographic, clinico-biological and endoscopic data, compared to the control group that encountered the rest of the patients with UDB. Results:Out of 2104 patients with non-variceal UDB, 31/2104 (1.5%) presented DL, 19/31(61.3%) male and 12/31(38.7%) female, mean age 63 ± 12.83. Diabetes mellitus was present in 35.5% cases. The mean value of hemoglobin was significantly lower in Dieulafoy group 7 ± 2.69 vs. 8 ± 3.28 in the control group, p=0.05, thus a significantly larger number of blood units per patient were needed in this group (p<0.0001). Re-bleebing was encountered significantly more often in Dieulafoy vs. control group: 7/31(22.6%) vs. 173/2074 (8.34%), p=0.03; surgery was needed in 3/31(9.7%) Dieulafoy patients. Endoscopic haemostasis was achieved most frequently by using combined treatment. The use of anticoagulants had a significant influence in the development of DL (p=0.019).Conclusion: DL may cause massive bleeding and is associated with a high rate of re-bleeding. Patients present comorbidities, diabetes mellitus being mostly associated with this condition. Anticoagulants represent risk factors highly associated with DL.

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Section: Discussionmentioning

confidence: 99%

Clinical Features, Endoscopic Management and Outcome of Patients with Non-variceal Upper Digestive Bleeding by Dieulafoy Lesion

Goldiş¹,

Lupușoru²,

Lazăr³

2017

Biol Med

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“…A total of 66 cases included gastric bleeding (66/234; 28.2%) [Sung et al 2011;Chen et al 2012;Fujita, 2012;Leblanc et al 2013;Smith et al 2013Smith et al , 2014Stanley et al 2013;Yau et al 2014;Sulz et al 2014;Giday et al 2011Giday et al , 2013 and 15 cases of esophageal bleeding (15/234; 6.4%) [Chen et al 2012;Leblanc et al 2013;Yau et al 2014;Smith et al 2014;Sulz et al 2014;Paganelli et al 2014]. A total of 62 cases (62/234; 26.5%) of duodenal bleeding were reported [Sung et al 2011; Leblanc et al 2013;Sargon and Laurie, 2013;Yau et al 2014;Smith et al 2014;Sulz et al 2014;Moosavi et al 2013]. Ibrahim and colleagues studied nine cases of bleeding at the gastroesophageal junction (9/234; 3.85%) [Ibrahim et al 2013].…”

Section: Location Of Bleedingmentioning

confidence: 99%

“…Leblanc and colleagues and Smith and coworkers used hemostatic powder to control bleeding after completion of endoscopic mucosal resection (EMR) [Leblanc et al 2013;Smith et al 2014]. A total of five of the studies reported successfully treated cases of post-polypectomy bleeding from a clipped sessile polyp in the cecum, rectum, transverse and ascending colon, a high-grade tubular adenoma in the rectum, Dieulafoy lesions, and radiation proctitis [Soulellis et al 2013;Yau et al 2014;Smith et al 2014;Holster et al 2014;Sulz et al 2014]. Hemospray efficacy in achieving hemostasis was demonstrated in gastric antral vascular ectasias (GAVE) and in post-sphincterotomy bleeding [Smith et al 2014;Sulz et al 2014;Moosavi et al 2013] Forrest classification Of the 81 bleeding peptic ulcer cases in the human subjects, 38.3% (31/81) were classified as Forrest 1a and 61.7% (50/81) as Forrest 1b.…”

Section: Source Of Bleedingmentioning

confidence: 99%

Hemostatic powder spray: a new method for managing gastrointestinal bleeding

Changela

Papafragkakis

Ofori

et al. 2015

Therap Adv Gastroenterol

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Gastrointestinal bleeding is a leading cause of morbidity and mortality in the United States. The management of gastrointestinal bleeding is often challenging, depending on its location and severity. To date, widely accepted hemostatic treatment options include injection of epinephrine and tissue adhesives such as cyanoacrylate, ablative therapy with contact modalities such as thermal coagulation with heater probe and bipolar hemostatic forceps, noncontact modalities such as photodynamic therapy and argon plasma coagulation, and mechanical hemostasis with band ligation, endoscopic hemoclips, and over-the-scope clips. These approaches, albeit effective in achieving hemostasis, are associated with a 5-10% rebleeding risk. New simple, effective, universal, and safe methods are needed to address some of the challenges posed by the current endoscopic hemostatic techniques. The use of a novel hemostatic powder spray appears to be effective and safe in controlling upper and lower gastrointestinal bleeding. Although initial reports of hemostatic powder spray as an innovative approach to manage gastrointestinal bleeding are promising, further studies are needed to support and confirm its efficacy and safety. The aim of this study was to evaluate the technical feasibility, clinical efficacy, and safety of hemostatic powder spray (Hemospray, Cook Medical, Winston-Salem, North Carolina, USA) as a new method for managing gastrointestinal bleeding. In this review article, we performed an extensive literature search summarizing case reports and case series of Hemospray for the management of gastrointestinal bleeding. Indications, features, technique, deployment, success rate, complications, and limitations are discussed. The combined technical and clinical success rate of Hemospray was 88.5% (207/234) among the human subjects and 81.8% (9/11) among the porcine models studied. Rebleeding occurred within 72 hours post-treatment in 38 patients (38/234; 16.2%) and in three porcine models (3/11; 27.3%). No procedure-related adverse events were associated with the use of Hemospray. Hemospray appears to be a safe and effective approach in the management of gastrointestinal bleeding.

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“…É aplicado sobre as lesões com sangramento ativo, e seu mecanismo de ação é baseado na absorção rápida de água, de modo a formar uma barreira mecânica sobre o ponto de sangramento. 28 Em um projeto piloto coordenado por Sung et al, a eficácia do hemospray foi avaliada em 20 pacientes com sangramento confirmado devido à doença ulcerosa péptica (Forrest Ia e Ib). 95% dos pacientes apresentaram hemostasia inicial, e um paciente possuía pseudoaneurisma, sendo necessária a embolização arterial.…”

Section: Métodos Mecânicosunclassified

Modalidades De Terapia Endoscópica Frente À Hemorragia Digestiva Alta Não-Varicosa

Sakuragi¹,

Bergamasco²,

Merlini³

2015

Bjim

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RESUMOA hemorragia digestiva alta não-varicosa ainda é uma frequente emergência médica, em especial nos pacientes com doença ulcerosa péptica. Estima-se uma incidência de até 99 casos por ano em 100.000 habitantes. Os locais de sangramento compreendem o esôfago, o estômago e o duodeno -porção acima do ligamento de Treitz. Embora a maioria dos episódios cesse espontaneamente, uma parcela expressiva de pacientes necessita de intervenção endoscópica. O presente estudo objetiva revisar as modalidades de terapia disponíveis por meio de endoscopia digestiva alta: injetáveis, termocoagulação, mecânicas, e mais recentemente, o hemospray; e dessa forma, avaliar a eficácia em termos de hemostasia, bem como as taxas de ressangramento e complicações. PALAVRAS-CHAVE: hemorragia digestiva alta não-varicosa; endoscopia digestiva alta; hemostase endoscópica. ABSTRACTThe nonvariceal upper gastrointestinal bleeding remains a common medical emergency, especially in patients with peptic ulcers. There is estimated an incidence of up 99 cases per year in 100.000 inhabitants. The sites of bleeding include the esophagus, stomach and duodenum -the portion above the ligament of Treitz. Although most episodes cease spontaneously, a significant proportion requires endoscopic intervention. This study aims to review the available modalities of endoscopic therapies: injection, thermocoagulation, mechanical, and more recently, hemospray; and thus, evaluate the effectiveness in terms os hemostasis, as well as the rates of rebleeding and complications.

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Safety and Efficacy of Hemospray^®in Upper Gastrointestinal Bleeding

Abstract: The high rates of both acute hemostasis and recurrent bleeding suggest that Hemospray may be used in high-risk cases as a temporary measure or a bridge toward more definitive therapy.

Cited by 88 publications

References 18 publications

Clinical Features, Endoscopic Management and Outcome of Patients with Non-variceal Upper Digestive Bleeding by Dieulafoy Lesion

Clinical Features, Endoscopic Management and Outcome of Patients with Non-variceal Upper Digestive Bleeding by Dieulafoy Lesion

Hemostatic powder spray: a new method for managing gastrointestinal bleeding

Modalidades De Terapia Endoscópica Frente À Hemorragia Digestiva Alta Não-Varicosa

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Safety and Efficacy of Hemospray®in Upper Gastrointestinal Bleeding

Abstract: The high rates of both acute hemostasis and recurrent bleeding suggest that Hemospray may be used in high-risk cases as a temporary measure or a bridge toward more definitive therapy.

Cited by 88 publications

References 18 publications

Clinical Features, Endoscopic Management and Outcome of Patients with Non-variceal Upper Digestive Bleeding by Dieulafoy Lesion

Clinical Features, Endoscopic Management and Outcome of Patients with Non-variceal Upper Digestive Bleeding by Dieulafoy Lesion

Hemostatic powder spray: a new method for managing gastrointestinal bleeding

Modalidades De Terapia Endoscópica Frente À Hemorragia Digestiva Alta Não-Varicosa

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Product

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Safety and Efficacy of Hemospray^®in Upper Gastrointestinal Bleeding