OVER-THE-SCOPE-CLIP IS AN EFFECTIVE ENDOSCOPIC MONOTHERAPY FOR SEVERE ACUTE UPPER NON-VARICEAL GASTROINTESTINAL BLEEDING

Introduction:

The over-the-scope-clip (OTSC) has proven useful as a rescue therapy for GI bleeding. Currently, various case reports, series and studies have shown that the OTSC device is effective as a first line therapy for upper GI bleeding lesions including peptic ulcer, Dieulafoy lesions and Mallory Weiss tears.

Aim:

The aim of this educational video is to discuss the potential utility of OTSC as primary hemostatic device for acute upper GI bleeding.

Results:

We present several examples of severe upper GI bleeding treated effectively with OTSC. We discuss all current options to treat upper GI bleeding, such as injection, thermal, clipping and tamponading devices. We also expand on the common problems encountered in clinical practice, including lesions in difficult locations, anticoagulation and patients with in poor clinical condition. Various examples of difficult lesions are shown. Furthermore, a step-by-step approach on how to use this novel device is presented.

Discussion:

Due to its special configuration and easiness of deployment the OTSC system is now being used as initial hemostatic monotherapy in upper GI bleeding.

Conclusions:

Whereas previous data have shown that OTSC was a useful alternative as a rescue therapy for severe upper GI bleeding, current data show that this device is a useful mon-therapy to achieve hemostasis. Its use appears effective, efficient, easy and safe. We believe that this therapy should be added to the routine armamentarium of the endoscopist treating GI bleeding emergencies.