Endoscopy 2019; 51(04): S63
DOI: 10.1055/s-0039-1681354
ESGE Days 2019 oral presentations
Friday, April 5, 2019 14:30 – 16:30: GI bleeding Club C
Georg Thieme Verlag KG Stuttgart · New York

CLINICAL EFFECTIVENESS OF HEMOSPRAY IN UPPER GASTROINTESTINAL BLEEDING: EXPERIENCE FROM “REAL WORLD” CLINICAL PRACTICE IN A TERTIARY REFERRAL CENTRE

M Fraile-López
1   Gastroenterology, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
2   NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom
,
W Fateen
2   NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom
,
J Ortíz Fernández-Sordo
2   NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom
,
K Ragunath
2   NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Hemospray is an useful endoscopic haemostatic powder for the management of gastrointestinal bleeding. Its role within the therapeutic algorithm of upper gastrointestinal bleeding (UGIB) is not well defined. Its usage is generally aimed at immediate but temporary control of UGIB to allow time for definitive therapy, spontaneous control or for palliation. We aimed to describe:1) indications and effectiveness of endoscopic haemostasis in UGIB. 2) to describe adverse events and re-bleeding rates.

Methods:

We collected data of all patients treated with Hemospray at our Institution for the management of UGIB between August 2013 to October 2018. Technical success was defined as the correct assembly of device and application. Immediate success was defined as bleeding cessation within 5 minutes after application. Combination therapy was its use with standard hemostatic methods and rescue therapy when standard methods have failed.

Results:

A total of 85 patients were included for analysis (54.7% male), mean age 68.3 ± 16.73 years. Hemospray was used for control of bleeding duodenal ulcers in 37.7% (n = 32), bleeding malignancy in 16.5% (n = 14) and post procedure bleeding in 14.1% (n = 12; 8 post-EMR; 2 post-biliary sphincterotomy; 1 post-ESD; 1 post-ampullectomy). Overall immediate haemostasis success was 89.6%. Haemospray was used as a rescue therapy in 38.8% (n = 33), single modality in 37.6% (n = 32) and combination therapy in 23.5% (n = 20) achieving immediate haemostasis in 87.8%; 85.7%; 85% respectively with no statistical differences between the three groups (p = 0.57). Overall technical success was 97.7%, in 2 cases blockage of 10F catheter occurred. No patient related side effects were seen. Global re-bleeding rate was 12.8%, (3.5%< 24h; 4.7% 24 – 72h; 4.8%> 72h), with no statistical differences related to treatment modalities (p = 0.86).

Conclusions:

In this "real world" clinical practice, Hemospray is an effective and safe treatment for upper bleeding regardless its use as a single, combination or rescue therapy.