Efficacy of a novel hemostatic adhesive powder in patients with refractory upper gastrointestinal bleeding: a pilot study

Abstract Background A new hemostatic adhesive powder (UI-EWD) has been developed to reduce the high re-bleeding rates associated with the currently available hemostatic powders. The current study aimed to assess the efficacy of UI-EWD as a salvage therapy for the treatment of refractory upper gastrointestinal bleeding (UGIB). Methods A total of 17 consecutive patients who had failed to achieve hemostasis with conventional endoscopic procedures and had undergone treatment with UI-EWD for endoscopic hemostasis in refractory UGIB were prospectively enrolled in the study. We evaluated the success rate of initial hemostasis and rate of re-bleeding within 30 days. Results All patients underwent successful UI-EWD application at the bleeding site. Initial hemostasis occurred in 16/17 patients (94 %). Re-bleeding within 30 days occurred in 3/16 patients (19 %) who had achieved initial hemostasis. In the second-look endoscopy after 24 hours, hydrogel from UI-EWD was found attached at the bleeding site in 11/16 patients (69 %). Conclusion UI-EWD has a high success rate for initial hemostasis in refractory UGIB and shows promising results in the prevention of re-bleeding.

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Novel hemostatic adhesive powder for nonvariceal upper gastrointestinal bleeding

Endoscopy International Open ◽

10.1055/a-0982-3194 ◽

2019 ◽

Vol 07 (12) ◽

pp. E1763-E1767

Author(s):

Jin-Seok Park ◽

Hyung Kil Kim ◽

Yong Woon Shin ◽

Kye Sook Kwon ◽

Don Haeng Lee

Keyword(s):

Gastrointestinal Bleeding ◽

Success Rate ◽

Medical Records ◽

Upper Gastrointestinal Bleeding ◽

Endoscopic Therapy ◽

Bleeding Site ◽

Success Rates ◽

Main Study ◽

Rebleeding Rate ◽

Upper Gastrointestinal

Abstract Background and study aims A new hemostatic adhesive powder (UI-EWD) was developed to reduce high rebleeding rates and technical challenges associated with application of currently available hemostatic powders. The aim of the current study was to assess performance of UI-EWD for nonvariceal upper gastrointestinal bleeding (NVUGIB). Patients and methods A total of 56 consecutive patients that received UI-EWD monotherapy for endoscopic hemostasis due to NVUGIB were retrospectively reviewed. Main study outcomes were success rates with immediate hemostasis and rebleeding within 30 days. Outcomes were analyzed by reviewing patient medical records. Results Etiologies of bleeding were: post-endoscopic therapy bleeding in 46 (82.1 %), peptic ulcer in 8 (14.3 %), tumor in 1 (1.8 %), and other in 1 (1.8 %). UI-EWD was successfully applied at bleeding site in all cases. The success rate of immediate hemostasis was 96.4 % (54/56), and the 30-day rebleeding rate among patients that achieved immediate hemostasis was 3.7 % (2/54). No adverse event related to use of UI-EWD occurred. Conclusion UI-EWD was found to have a high immediate hemostasis success rate in NVUGIB when used as monotherapy and showed promising results in terms of preventing rebleeding.

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Effectiveness of TC-325 (Hemospray) for treatment of diffuse or refractory upper gastrointestinal bleeding – a single center experience

Endoscopy International Open ◽

10.1055/s-0043-118794 ◽

2017 ◽

Vol 05 (11) ◽

pp. E1159-E1164 ◽

Cited By ~ 11

Author(s):

Oscar Cahyadi ◽

Markus Bauder ◽

Benjamin Meier ◽

Karel Caca ◽

Arthur Schmidt

Keyword(s):

Gastrointestinal Bleeding ◽

Salvage Therapy ◽

Upper Gastrointestinal Bleeding ◽

Clinical Success ◽

Treatment Algorithm ◽

Endoscopic Hemostasis ◽

Ulcer Bleeding ◽

Recurrent Bleeding ◽

Technical Success ◽

Upper Gastrointestinal

Abstract Background and study aims TC-325 (Hemospray, Cook Medical) is a powder agent for endoscopic hemostasis in patients with upper gastrointestinal bleeding (UGIB). Although most publications are based on case-reports and retrospective studies, data on efficacy are promising. Here we report our experience with TC-325 for diffuse or refractory UGIB. Patients and methods Data on patients receiving TC-325 for endoscopic hemostasis from November 2013 to February 2017 at our center were analyzed retrospectively. Primary endpoints were technical success (successful immediate hemostasis) and clinical success (effective hemostasis and no recurrent bleeding). Secondary endpoints were recurrent bleeding within 3 and 7 days, hospital mortality and TC-325 associated complications. TC-325 was used for bleeding not amenable to standard endoscopic treatment (e. g. diffuse bleeding) or as salvage therapy after failure of conventional methods Results Fifty-two patients received TC-325 treatment. Most of the patients were treated for peptic ulcer bleeding (18/52 patients, 34.6 %) and post-interventional bleeding (13/52 patients, 25 %). Hemospray was used in 23/52 (44.2 %) patients as monotherapy and in 29/52 (55.8 %) patients as a salvage therapy. Application of the powder on the bleeding source was successful in all patients with no therapy-related adverse events (AEs). Immediate hemostasis was achieved in 51/52 (98.1 %) patients. Recurrent bleeding within 3 and 7 days was observed in 22/51 and 25/51 patients respectively (43.1 % and 49 %). The overall clinical success was 56.9 % on day 3 and 51 % on day 7. Total mortality was 15.4 % (8 patients), bleeding associated mortality was 3.8 % (2 patients). There were no therapy-related AEs. Conclusions TC-325 showed a high technical success rate as monotherapy for bleeding sources not amenable to standard methods or as an “add-on” therapy after unsuccessful hemostasis. However, rebleeding was frequent in this cohort and further studies are warranted to exactly define a treatment algorithm for TC-325 use.

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Safety and Efficacy of the Noncessation Method of Antithrombotic Agents after Emergency Endoscopic Hemostasis in Patients with Nonvariceal Upper Gastrointestinal Bleeding: A Multicenter Pilot Study

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2021/6672440 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Daisuke Yamaguchi ◽

Naoyuki Tominaga ◽

Koichi Miyahara ◽

Nanae Tsuruoka ◽

Yasuhisa Sakata ◽

...

Keyword(s):

Pilot Study ◽

Propensity Score ◽

Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleeding ◽

Endoscopic Hemostasis ◽

Antithrombotic Agents ◽

Safety And Efficacy ◽

Group A ◽

Group B ◽

Upper Gastrointestinal

Background and Aims. The present study aimed to clarify the safety and efficacy of the noncessation method of antithrombotic agents after emergency endoscopic hemostasis in patients with nonvariceal upper gastrointestinal bleeding (UGIB). Methods. In this multicenter, prospective, pilot study, we performed emergency endoscopic hemostasis for nonvariceal UGIB in patients taking antithrombotic agents and resumed the medications without a cessation period (group A). The clinical characteristics, types of antithrombotic agents, UGIB etiology, treatment outcome, and adverse events were evaluated. We used propensity score matching to compare treatment outcomes and adverse events with our previous cohort (group B) in whom antithrombotic agents were transiently discontinued after emergency endoscopic hemostasis. Results. Forty-three consecutive patients were prospectively enrolled. The main antithrombotic agents were low-dose aspirin and direct oral anticoagulants; 11 patients (25.6%) were taking multiple antithrombotics. Peptic ulcers were the main cause of bleeding (95.4%). Endoscopic hemostasis was successful in all patients and the incidence of rebleeding within a month was 7.0%. Propensity score matching created 40 matched pairs. Endoscopic hemostasis was performed by soft coagulation significantly more frequently in group A than in group B (97.5% versus 60.0%, P < 0.001). Neither the rebleeding rate within a month nor thromboembolic event rate was different between the two groups. However, the mean duration of hospitalization was significantly shorter in group A than in group B (8.6 ± 5.2 d versus 14.4 ± 7.1 d, P < 0.001). Conclusions. Antithrombotic agents possibly can be continued after successful emergency endoscopic hemostasis for nonvariceal UGIB.

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Efficacy of a novel hemostatic adhesive powder in patients with upper gastrointestinal tumor bleeding

BMC Gastroenterology ◽

10.1186/s12876-021-01611-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jongbeom Shin ◽

Boram Cha ◽

Jin-Seok Park ◽

Weonjin Ko ◽

Kye Sook Kwon ◽

...

Keyword(s):

Success Rate ◽

Salvage Therapy ◽

Upper Gastrointestinal Bleeding ◽

Effective Control ◽

Success Rates ◽

Gastrointestinal Tumor ◽

Bleeding Rate ◽

Tumor Bleeding ◽

Hemostatic Powder ◽

Upper Gastrointestinal

Abstract Background Gastrointestinal tumor bleeding remains a clinical challenge because it is difficult to treat with conventional endoscopic hemostatic options. Recently, an endoscopic hemostatic powder (UI-EWD) was developed and reported to provide effective control of upper gastrointestinal bleeding. The aim of current study was to evaluate the feasibility and efficacy of this novel hemostatic powder in tumor bleeding. Methods A total of 41 consecutive patients with upper gastrointestinal tumor bleeding were included. UI-EWD was applied in all patients as an auxiliary hemostatic method as a salvage therapy or monotherapy during endoscopic treatment. Hemostasis success rates, adverse event related to UI-EWD, and rates of re-bleeding were evaluated. Results In all cases, UI-EWD application was successful at tumor bleeding sites. Immediate hemostasis occurred in 40/41 (97.5%) patients, and re-bleeding within 28 days occurred in 10 of 40 (22.5%) patients that achieved initial hemostasis. The success rate of immediate hemostasis for UI-EWD monotherapy was 100% (23/23). The re-bleeding rate at 28 days after UI-EWD monotherapy was 26.1% (6/23). No adverse events associated with UI-EWD application were encountered. Conclusions The success rate of UI-EWD for immediate hemostasis in cases of GI tumor bleeding was excellent and UI-EWD produced promising results with respect to the prevention of re-bleeding. Based on these results, we suggest that UI-EWD be considered an effective salvage therapy or even monotherapy for GI tumor bleeding.

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