Hemostatic spray powder TC-325 in the primary endoscopic treatment of peptic ulcer-related bleeding: Multicenter international registry

Mohamed Hussein, Durayd Alzoubaidi, Miguel Fraile Lopez, Michael Weaver, Jacobo Ortiz-Fernandez-Sordo, Paul Bassett, Johannes W. Rey, Bu Hussain Hayee, Edward Despott, Alberto Murino, Sulleman Moreea, Philip Boger, Jason Dunn, Inder Mainie, David Graham, Daniel K. Mullady, Dayna S. Early, Krish Ragunath, John T. Anderson, Pradeep BhandariMartin Goetz, Ralf Kiesslich, Emmanuel Coron, Laurence B. Lovat, Rehan Haidry

Research output: Contribution to journalArticlepeer-review

Abstract

Background  Upper gastrointestinal bleeding (UGIB) is a leading cause of morbidity and is associated with a 2 % - 17 % mortality rate in the UK and USA. Bleeding peptic ulcers account for 50 % of UGIB cases. Endoscopic intervention in a timely manner can improve outcomes. Hemostatic spray is an endoscopic hemostatic powder for GI bleeding. This multicenter registry was created to collect data prospectively on the immediate endoscopic hemostasis of GI bleeding in patients with peptic ulcer disease when hemostatic spray is applied as endoscopic monotherapy, dual therapy, or rescue therapy. Methods  Data were collected prospectively (January 2016 - March 2019) from 14 centers in the UK, France, Germany, and the USA. The application of hemostatic spray was decided upon at the endoscopist's discretion. Results  202 patients with UGIB secondary to peptic ulcers were recruited. Immediate hemostasis was achieved in 178/202 patients (88 %), 26/154 (17 %) experienced rebleeding, 21/175 (12 %) died within 7 days, and 38/175 (22 %) died within 30 days (all-cause mortality). Combination therapy of hemostatic spray with other endoscopic modalities had an associated lower 30-day mortality (16 %, P  < 0.05) compared with monotherapy or rescue therapy. There were high immediate hemostasis rates across all peptic ulcer disease Forrest classifications. Conclusions  This is the largest case series of outcomes of peptic ulcer bleeding treated with hemostatic spray, with high immediate hemostasis rates for bleeding peptic ulcers.

Original languageEnglish
Pages (from-to)36-43
Number of pages8
JournalEndoscopy
Volume53
Issue number1
DOIs
StatePublished - Jan 1 2021
Externally publishedYes

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