Dennis M Jensen1, Gustavo A Machicado, Ken Hirabayashi. 1. CURE Hemostasis Research Group, CURE Digestive Diseases Research Center, Bldg 115, Rm 318, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, Los Angeles, CA 90073-1003, USA.
Abstract
BACKGROUND: Mechanical closure of bleeding vessels is clinically appealing, and several types of hemoclips are now marketed for endoscopic hemostasis of nonvariceal lesions. No comparative data have been reported on ease of clip placement, hemostasis efficacy, or clip retention rates on bleeding ulcers. OBJECTIVE: To compare 3 different types of hemoclips for hemostasis of bleeding ulcers. DESIGN: Randomized controlled study. SUBJECTS: Seven adult dogs with prehepatic portal hypertension were heparinized, and acute gastric ulcers were made with jumbo biopsy forceps. Animals had oral proton pump inhibitors daily and weekly endoscopies to quantitate clip retention and ulcer healing. INTERVENTIONS: Bleeding ulcers were randomized in pairs (2 for each treatment/dog) to endoscopic hemoclip treatment or control. MAIN OUTCOME MEASUREMENTS: Initial times and success of deployment, hemostasis efficacy, clip retention rates, and ulcer healing during endoscopic follow-ups. RESULTS: There was no difference in initial hemostasis rates of hemoclips, and no major complications occurred. Ulcer healing times were faster (Resolution Clip [RC] or TriClip [TC]) or similar (QuickClip2 [QC]) to controls. Clip retention at 1 week was significantly less with TC and, at 3 to 7 weeks, was significantly higher with RC. CONCLUSIONS: (1) For the 3 hemoclip devices, initial hemostasis rates were 100%, but all devices required similar learning time to place clips successfully. (2) Short-term retention rates of TC were significantly less than QC or RC. (3) Long-term clip retention was significantly higher with RC. (4) All 3 hemoclips were safe, and none interfered with ulcer healing.
BACKGROUND: Mechanical closure of bleeding vessels is clinically appealing, and several types of hemoclips are now marketed for endoscopic hemostasis of nonvariceal lesions. No comparative data have been reported on ease of clip placement, hemostasis efficacy, or clip retention rates on bleeding ulcers. OBJECTIVE: To compare 3 different types of hemoclips for hemostasis of bleeding ulcers. DESIGN: Randomized controlled study. SUBJECTS: Seven adult dogs with prehepatic portal hypertension were heparinized, and acute gastric ulcers were made with jumbo biopsy forceps. Animals had oral proton pump inhibitors daily and weekly endoscopies to quantitate clip retention and ulcer healing. INTERVENTIONS:Bleeding ulcers were randomized in pairs (2 for each treatment/dog) to endoscopic hemoclip treatment or control. MAIN OUTCOME MEASUREMENTS: Initial times and success of deployment, hemostasis efficacy, clip retention rates, and ulcer healing during endoscopic follow-ups. RESULTS: There was no difference in initial hemostasis rates of hemoclips, and no major complications occurred. Ulcer healing times were faster (Resolution Clip [RC] or TriClip [TC]) or similar (QuickClip2 [QC]) to controls. Clip retention at 1 week was significantly less with TC and, at 3 to 7 weeks, was significantly higher with RC. CONCLUSIONS: (1) For the 3 hemoclip devices, initial hemostasis rates were 100%, but all devices required similar learning time to place clips successfully. (2) Short-term retention rates of TC were significantly less than QC or RC. (3) Long-term clip retention was significantly higher with RC. (4) All 3 hemoclips were safe, and none interfered with ulcer healing.
Authors: Eric Wee; Mathew Philip Sachin; Uthamanand Chinnappa; Su Chang; Cherng Hann Benjamin Yip Journal: Dig Dis Sci Date: 2015-03-31 Impact factor: 3.199
Authors: Mena Boules; Julietta Chang; Ivy N Haskins; Gautam Sharma; Dvir Froylich; Kevin El-Hayek; John Rodriguez; Matthew Kroh Journal: World J Gastrointest Endosc Date: 2016-09-16
Authors: Shou-Jiang Tang; Homero Rivas; Linda Tang; Luis F Lara; Jayaprakash Sreenarasimhaiah; Don C Rockey Journal: Obes Surg Date: 2007-09 Impact factor: 4.129