Endoscopy 2021; 53(01): 36-43
DOI: 10.1055/a-1186-5360
Original article

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

Mohamed Hussein
 1  Division of Surgery and Interventional Science, University College London, London, United Kingdom
,
Durayd Alzoubaidi
 1  Division of Surgery and Interventional Science, University College London, London, United Kingdom
,
Miguel-Fraile Lopez
 2  Nottingham University Hospitals, Nottingham, United Kingdom
,
Michael Weaver
 3  Washington University School of Medicine in St. Louis, St. Louis, Missouri, United States
,
Jacobo Ortiz-Fernandez-Sordo
 2  Nottingham University Hospitals, Nottingham, United Kingdom
,
Paul Bassett
 4  Statsconsultancy Ltd., Amersham, United Kingdom
,
Johannes W. Rey
 5  Department of Gastroenterology, Klinikum Osnabruck, Osnabruck, Germany
,
Bu Hussain Hayee
 6  Department of Gastroenterology, Kings College Hospital, London, United Kingdom
,
Edward Despott
 7  Department of Gastroenterology, The Royal Free Hospital, London, United Kingdom
,
Alberto Murino
 7  Department of Gastroenterology, The Royal Free Hospital, London, United Kingdom
,
Sulleman Moreea
 8  Department of Gastroenterology, Bradford Teaching Hospitals Foundation Trust, Bradford, United Kingdom
,
Philip Boger
 9  Department of Gastroenterology, University Hospital Southampton, Southampton, United Kingdom
,
Jason Dunn
10  Department of Gastroenterology, Guy’s and St Thomas’ Foundation Trust Hospitals, London, United Kingdom
,
Inder Mainie
11  Department of Gastroenterology, Belfast Health and Social Care Trust, Belfast, United Kingdom
,
David Graham
12  Department of Gastroenterology, University College London Hospital, London, United Kingdom
,
Daniel K. Mullady
 3  Washington University School of Medicine in St. Louis, St. Louis, Missouri, United States
,
Dayna S. Early
 3  Washington University School of Medicine in St. Louis, St. Louis, Missouri, United States
,
Krish Ragunath
 2  Nottingham University Hospitals, Nottingham, United Kingdom
,
John T. Anderson
13  Department of Gastroenterology, Gloucestershire Hospitals NHS Foundation trust, Cheltenham, United Kingdom
,
Pradeep Bhandari
14  Department of Gastroenterology, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom
,
Martin Goetz
15  Department of Gastroenterology, Tübingen University Hospital, Tübingen, Germany
,
Ralf Kiesslich
16  Horst Schmidt Kliniken, Wiesbaden, Germany
,
Emmanuel Coron
17  Department of Gastroenterology, Centre Hospitalier Universitaire, Nantes, France
,
Laurence B. Lovat
 1  Division of Surgery and Interventional Science, University College London, London, United Kingdom
,
Rehan Haidry
 1  Division of Surgery and Interventional Science, University College London, London, United Kingdom
12  Department of Gastroenterology, University College London Hospital, London, United Kingdom
› Author Affiliations

Abstract

Background Upper gastrointestinal bleeding (UGIB) is a leading cause of morbidity and is associated with a 2 % – 17 % mortality rate in the UK and USA. Bleeding peptic ulcers account for 50 % of UGIB cases. Endoscopic intervention in a timely manner can improve outcomes. Hemostatic spray is an endoscopic hemostatic powder for GI bleeding. This multicenter registry was created to collect data prospectively on the immediate endoscopic hemostasis of GI bleeding in patients with peptic ulcer disease when hemostatic spray is applied as endoscopic monotherapy, dual therapy, or rescue therapy.

Methods Data were collected prospectively (January 2016 – March 2019) from 14 centers in the UK, France, Germany, and the USA. The application of hemostatic spray was decided upon at the endoscopist’s discretion.

Results 202 patients with UGIB secondary to peptic ulcers were recruited. Immediate hemostasis was achieved in 178/202 patients (88 %), 26/154 (17 %) experienced rebleeding, 21/175 (12 %) died within 7 days, and 38/175 (22 %) died within 30 days (all-cause mortality). Combination therapy of hemostatic spray with other endoscopic modalities had an associated lower 30-day mortality (16 %, P < 0.05) compared with monotherapy or rescue therapy. There were high immediate hemostasis rates across all peptic ulcer disease Forrest classifications.

Conclusions This is the largest case series of outcomes of peptic ulcer bleeding treated with hemostatic spray, with high immediate hemostasis rates for bleeding peptic ulcers.

Supplementary material



Publication History

Received: 04 December 2019

Accepted: 26 May 2020

Publication Date:
26 May 2020 (online)

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