Hemospray treatment is effective for lower gastrointestinal bleeding

I. Lisanne Holster; Enric Brullet; Ernst J. Kuipers; Rafel Campo; Alberto Fernández-Atutxa; Eric T. T. L. Tjwa

doi:10.1055/s-0033-1344988

Endoscopy, Table of Contents

Endoscopy 2014; 46(01): 75-78
DOI: 10.1055/s-0033-1344988

Case report/series

Hemospray treatment is effective for lower gastrointestinal bleeding

I. Lisanne Holster

¹Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands

,

Enric Brullet

²Department of Digestive Diseases, Hospital of Sabadell, Corporació Sanitaria Universitaria Parc Taulí, Sabadell, Spain and Networked Biomedical Research Center for Hepatic and Digestive Diseases (CIBERehd), Spain

,

Ernst J. Kuipers

¹Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands

,

Rafel Campo

²Department of Digestive Diseases, Hospital of Sabadell, Corporació Sanitaria Universitaria Parc Taulí, Sabadell, Spain and Networked Biomedical Research Center for Hepatic and Digestive Diseases (CIBERehd), Spain

,

Alberto Fernández-Atutxa

²Department of Digestive Diseases, Hospital of Sabadell, Corporació Sanitaria Universitaria Parc Taulí, Sabadell, Spain and Networked Biomedical Research Center for Hepatic and Digestive Diseases (CIBERehd), Spain

,

Eric T. T. L. Tjwa

¹Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands

› Author Affiliations

Abstract

Acute lower gastrointestinal bleeding (LGIB) is diverse in origin and can be substantial, requiring urgent hemostasis. Hemospray is a promising novel hemostatic agent for upper gastrointestinal bleeding (UGIB). It has been claimed in a small series that the use of Hemospray is also feasible in LGIB. We aimed to expand our knowledge of the application of Hemospray for the treatment of LGIB in a wider range of conditions to further define the optimal patient population for this new therapeutic modality.

We analyzed the outcomes of nine unselected consecutive patients with active LGIB treated with Hemospray in two major hospitals in Europe. Initial hemostasis was achieved after Hemospray application in all patients. Rebleeding occurred in two patients (22 %) who were on acetyl salicylic acid and presented with spurting bleeds. These preliminary data show that Hemospray can be effective in the management of LGIB, but suggest cautious use for patients on antithrombotic therapy and spurting bleeds.

Full Text

References

References
1 Lanas A, Garcia-Rodriguez LA, Polo-Tomas M et al. Time trends and impact of upper and lower gastrointestinal bleeding and perforation in clinical practice. Am J Gastroenterol 2009; 104: 1633-1641
2 Zuccaro G. Epidemiology of lower gastrointestinal bleeding. Best Pract Res Clin Gastroenterol 2008; 22: 225-232
3 Sung JJ, Luo D, Wu JC et al. Early clinical experience of the safety and effectiveness of Hemospray in achieving hemostasis in patients with acute peptic ulcer bleeding. Endoscopy 2011; 43: 291-295
4 Morris AJ, Smith LA, Stanley A et al. Hemospray for non-variceal upper gastrointestinal bleeding: results of the seal dataset (survey to evaluate the application of hemospray in the luminal tract). Gastrointest Endosc 2012; 75 (Suppl. 01) AB228
5 Soulellis CA, Carpentier S, Chen YI et al. Lower GI hemorrhage controlled with endoscopically applied TC-325 (with videos). Gastrointest Endosc 2013; 77: 504-507
6 Schulman S, Kearon C. Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients. J Thromb Haemost 2005; 3: 692-694
7 Holster IL, Kuipers EJ, Tjwa ET. Hemospray in the treatment of upper gastrointestinal hemorrhage in patients on antithrombotic therapy. Endoscopy 2013; 45: 63-66