TY - JOUR
T1 - Hemostatic powder TC-325 treatment of malignancy-related upper gastrointestinal bleeds
T2 - International registry outcomes
AU - Hussein, Mohamed
AU - Alzoubaidi, Durayd
AU - O'Donnell, Michael
AU - de la Serna, Alvaro
AU - Bassett, Paul
AU - Varbobitis, Ioannis
AU - Hengehold, Tricia
AU - Ortiz Fernandez-Sordo, Jacobo
AU - Rey, Johannes W.
AU - Hayee, Bu'Hussain
AU - Despott, Edward J.
AU - Murino, Alberto
AU - Graham, David
AU - Latorre, Melissa
AU - Moreea, Sulleman
AU - Boger, Phillip
AU - Dunn, Jason
AU - Mainie, Inder
AU - Mullady, Daniel
AU - Early, Dayna
AU - Ragunath, Krish
AU - Anderson, John
AU - Bhandari, Pradeep
AU - Goetz, Martin
AU - Kiesslich, Ralf
AU - Coron, Emmanuel
AU - Rodriguez de Santiago, Enrique
AU - Gonda, Tamas
AU - Gross, Seth A.
AU - Lovat, Laurence B.
AU - Haidry, Rehan
N1 - Funding Information:
M.H. received speaker fees (Cook Medical). R.H received educational grants to support research infrastructure from Medtronic Ltd, Cook Endoscopy (fellowship support), Pentax Europe, C2 Therapeutics, Beamline Diagnostic, Fractyl Ltd. A.M. acted as a consultant for Boston Scientific and GI supply and received academic grants from Fujifilm, Aquilant Endoscopy, Norgine, and Olympus. B.H. received research grants from Fujifilm EU, Olympus UK, Takeda Pharmaceuticals UK, AbbVie UK. The remaining authors have no conflicts of interests to declare. Declaration of conflict of interest:
Funding Information:
RH (Chief investigator) has received research grant support from Cook Endoscopy to support research infrastructure. LBL is supported by the National Institute for Health Research University College London Hospitals Biomedical Research Centre and the CRUK Experimental Cancer Medicine Centre at UCL. RH and LBL are supported by the Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS) at UCL (203145Z/16/Z). Financial support:
Publisher Copyright:
© 2021 The Authors. Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.
PY - 2021/11
Y1 - 2021/11
N2 - Background and Aim: Upper gastrointestinal tumors account for 5% of upper gastrointestinal bleeds. These patients are challenging to treat due to the diffuse nature of the neoplastic bleeding lesions, high rebleeding rates, and significant transfusion requirements. TC-325 (Cook Medical, North Carolina, USA) is a hemostatic powder for gastrointestinal bleeding. The aim of this study was to examine the outcomes of upper gastrointestinal bleeds secondary to tumors treated with Hemospray therapy. Methods: Data were prospectively collected on the use of Hemospray from 17 centers. Hemospray was used during emergency endoscopy for upper gastrointestinal bleeds secondary to tumors at the discretion of the endoscopist as a monotherapy, dual therapy with standard hemostatic techniques, or rescue therapy. Results: One hundred and five patients with upper gastrointestinal bleeds secondary to tumors were recruited. The median Blatchford score at baseline was 10 (interquartile range [IQR], 7–12). The median Rockall score was 8 (IQR, 7–9). Immediate hemostasis was achieved in 102/105 (97%) patients, 15% of patients had a 30-day rebleed, 20% of patients died within 30 days (all-cause mortality). There was a significant improvement in transfusion requirements following treatment (P < 0.001) when comparing the number of units transfused 3 weeks before and after treatment. The mean reduction was one unit per patient. Conclusions: Hemospray achieved high rates of immediate hemostasis, with comparable rebleed rates following treatment of tumor-related upper gastrointestinal bleeds. Hemospray helped in improving transfusion requirements in these patients. This allows for patient stabilization and bridges towards definitive surgery or radiotherapy to treat the underlying tumor.
AB - Background and Aim: Upper gastrointestinal tumors account for 5% of upper gastrointestinal bleeds. These patients are challenging to treat due to the diffuse nature of the neoplastic bleeding lesions, high rebleeding rates, and significant transfusion requirements. TC-325 (Cook Medical, North Carolina, USA) is a hemostatic powder for gastrointestinal bleeding. The aim of this study was to examine the outcomes of upper gastrointestinal bleeds secondary to tumors treated with Hemospray therapy. Methods: Data were prospectively collected on the use of Hemospray from 17 centers. Hemospray was used during emergency endoscopy for upper gastrointestinal bleeds secondary to tumors at the discretion of the endoscopist as a monotherapy, dual therapy with standard hemostatic techniques, or rescue therapy. Results: One hundred and five patients with upper gastrointestinal bleeds secondary to tumors were recruited. The median Blatchford score at baseline was 10 (interquartile range [IQR], 7–12). The median Rockall score was 8 (IQR, 7–9). Immediate hemostasis was achieved in 102/105 (97%) patients, 15% of patients had a 30-day rebleed, 20% of patients died within 30 days (all-cause mortality). There was a significant improvement in transfusion requirements following treatment (P < 0.001) when comparing the number of units transfused 3 weeks before and after treatment. The mean reduction was one unit per patient. Conclusions: Hemospray achieved high rates of immediate hemostasis, with comparable rebleed rates following treatment of tumor-related upper gastrointestinal bleeds. Hemospray helped in improving transfusion requirements in these patients. This allows for patient stabilization and bridges towards definitive surgery or radiotherapy to treat the underlying tumor.
KW - endoscopy
KW - malignancy
KW - non-variceal
KW - upper GI
KW - upper gastrointestinal bleeding
UR - http://www.scopus.com/inward/record.url?scp=85111123392&partnerID=8YFLogxK
U2 - 10.1111/jgh.15579
DO - 10.1111/jgh.15579
M3 - Article
C2 - 34132412
AN - SCOPUS:85111123392
SN - 0815-9319
VL - 36
SP - 3027
EP - 3032
JO - Journal of Gastroenterology and Hepatology (Australia)
JF - Journal of Gastroenterology and Hepatology (Australia)
IS - 11
ER -