Durayd Alzoubaidi1, Mohamed Hussein1, Radu Rusu2, Duncan Napier3, Selena Dixon4, Johannes W Rey5, Cora Steinheber6, Sina Jameie-Oskooei7, Martin Dahan8, Bu Hayee9, Shraddha Gulati9, Edward Despott7, Alberto Murino7, Sharmila Subramaniam10, Sulleman Moreea4, Phil Boger11, Maxworth Hu11, Patricia Duarte11, Jason Dunn2, Inder Mainie12, John McGoran12, David Graham13, John Anderson3, Pradeep Bhandari10, Martin Goetz6, Ralf Kiesslich14, Emmanuel Coron8, Laurence Lovat1, Rehan Haidry1,13. 1. Division of Surgery and Interventional Science, University College London (UCL), London, UK. 2. Department of Gastroenterology, Guy's and St Thomas' Foundation Trust Hospitals, London, UK. 3. Department of Gastroenterology, Gloucestershire Hospitals NHS Foundation Trust - Cheltenham General Hospital, Cheltenham, UK. 4. Department of Gastroenterology, Bradford Teaching Hospitals Foundation Trust, Bradford, UK. 5. Department of Gastroenterology, Clinic Osnabruck, Osnabruck, Germany. 6. Department of Gastroenterology, Tubingen University Hospital, Tubingen, Germany. 7. Department of Gastroenterology, The Royal Free Hospital, London, UK. 8. Department of Gastroenterology, University Hospital Centre, Nantes, France. 9. Department of Gastroenterology, Kings College London, London, UK. 10. Department of Gastroenterology, Portsmouth Hospitals NHS Trust, Portsmouth, UK. 11. Department of Gastroenterology, University Hospital Southampton, Southampton, UK. 12. Department of Gastroenterology, Belfast Trust, Belfast, UK. 13. Department of Gastroenterology, University College London Hospital (UCLH), London, UK. 14. Horst Schmidt Clinic, Wiesbaden, Germany.
Abstract
BACKGROUND AND AIM: Acute gastrointestinal bleeding carries poor outcomes unless prompt endoscopic hemostasis is achieved. Mortality in these patients remains significant. Hemospray is a novel intervention that creates a mechanical barrier over bleeding sites. We report the largest dataset of patient outcomes after treatment with Hemospray from an international multicenter registry. PATIENTS AND METHODS: Prospective data (Jan 2016-May 2018) from 12 centers across Europe were collected. Immediate hemostasis was defined as endoscopic cessation of bleeding within 5 min after application of Hemospray. Rebleeding was defined as subsequent drop in hemoglobin, hematemesis, persistent melena with hemodynamic compromise post-therapy. RESULTS: Three hundred and fourteen cases were recruited worldwide (231 males, 83 females). Median pretreatment Blatchford score was 11 (IQR: 8-14) and median complete Rockall score (RS) was 7 (IQR: 6-8) for all patients. Peptic ulcer disease (PUD) was the most common pathology (167/314 = 53%) and Forrest Ib the most common bleed type in PUD (100/167 = 60%). 281 patients (89.5%) achieved immediate hemostasis after successful endoscopic therapy with Hemospray. Rebleeding occurred in 29 (10.3%) of the 281 patients who achieved immediate hemostasis. Seven-day and 30-day all-cause mortality were 11.5% (36/314) and 20.1% (63/314), respectively (lower than the predicted rates as per the RS). Similar hemostasis rates were noted in the Hemospray monotherapy (92.4%), combination therapy (88.7%) and rescue therapy (85.5%) groups. CONCLUSIONS: These data show high rates of immediate hemostasis overall and in all subgroups. Rebleeding and mortality rates were in keeping/lower than predicted rates.
BACKGROUND AND AIM: Acute gastrointestinal bleeding carries poor outcomes unless prompt endoscopic hemostasis is achieved. Mortality in these patients remains significant. Hemospray is a novel intervention that creates a mechanical barrier over bleeding sites. We report the largest dataset of patient outcomes after treatment with Hemospray from an international multicenter registry. PATIENTS AND METHODS: Prospective data (Jan 2016-May 2018) from 12 centers across Europe were collected. Immediate hemostasis was defined as endoscopic cessation of bleeding within 5 min after application of Hemospray. Rebleeding was defined as subsequent drop in hemoglobin, hematemesis, persistent melena with hemodynamic compromise post-therapy. RESULTS: Three hundred and fourteen cases were recruited worldwide (231 males, 83 females). Median pretreatment Blatchford score was 11 (IQR: 8-14) and median complete Rockall score (RS) was 7 (IQR: 6-8) for all patients. Peptic ulcer disease (PUD) was the most common pathology (167/314 = 53%) and Forrest Ib the most common bleed type in PUD (100/167 = 60%). 281 patients (89.5%) achieved immediate hemostasis after successful endoscopic therapy with Hemospray. Rebleeding occurred in 29 (10.3%) of the 281 patients who achieved immediate hemostasis. Seven-day and 30-day all-cause mortality were 11.5% (36/314) and 20.1% (63/314), respectively (lower than the predicted rates as per the RS). Similar hemostasis rates were noted in the Hemospray monotherapy (92.4%), combination therapy (88.7%) and rescue therapy (85.5%) groups. CONCLUSIONS: These data show high rates of immediate hemostasis overall and in all subgroups. Rebleeding and mortality rates were in keeping/lower than predicted rates.
Authors: Muhammad Aziz; Simcha Weissman; Tej I Mehta; Shafae Hassan; Zubair Khan; Rawish Fatima; Yuriy Tsirlin; Ammar Hassan; Michael Sciarra; Ali Nawras; Amit Rastogi Journal: Ann Gastroenterol Date: 2020-01-20
Authors: Christoph R Werner; Lena Brücklmeier; Thomas Kratt; Nisar P Malek; Bence Sipos; Dörte Wichmann; Martin Götz Journal: Sci Rep Date: 2021-09-24 Impact factor: 4.379