The Over-The-Scope Clip (OTSC; Ovesco, Tübingen, Germany) is a novel endoscopic clipping
device designed for tissue approximation. The device has been used in the closure
of fistulas and perforations. We hereby report on a series of patients in whom OTSCs
were used for endoscopic control of refractory or major upper gastrointestinal bleeding
from lesions in the gastroduodenal tract between 1 July and 31 December 2012. Nine
patients were included (median age 72.5 years, range 39 – 91) with bleeding gastric
ulcers (n = 2), bleeding duodenal ulcers (n = 5), bleeding gastrointestinal stromal
tumor in the stomach (n = 1), and bleeding from ulcerative carcinoma of the pancreas
(n = 1). The median size of the ulcers was 2.5 cm (range 1 – 4). Six of the nine patients
had undergone previous endoscopic hemostasis. Technical success was achieved in all
patients and the clinical effectiveness was 77.8 %. The OTSC is a safe and effective
method of endoscopic hemostasis for major bleeding from miscellaneous upper gastrointestinal
causes and should be considered in patients with refractory bleeding after failure
of conventional methods of endoscopic hemostasis.
