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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(01): E52-E56
DOI: 10.1055/a-2221-7908
Original article

Through-the-scope clip retention rates and performance in a porcine model

Jad AbiMansour
1   Gastroenterology and Hepatology, Mayo Clinic, Rochester, United States (Ringgold ID: RIN6915)
,
Shunsuke Kamba
1   Gastroenterology and Hepatology, Mayo Clinic, Rochester, United States (Ringgold ID: RIN6915)
,
Louis-Michel Wong Kee Song
1   Gastroenterology and Hepatology, Mayo Clinic, Rochester, United States (Ringgold ID: RIN6915)
,
Elizabeth Rajan
1   Gastroenterology and Hepatology, Mayo Clinic, Rochester, United States (Ringgold ID: RIN6915)
› Author AffiliationsSupported by: STERIS Endoscopy
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Abstract

Background and study aims Limited comparative data exist to guide optimal through-the-scope (TTS) clip selection. The aim of this study was to compare the efficacy, retention, and safety of three industry-leading TTS clips on tissue that mimics common clinical scenarios.

Methods A survival study involving six domestic pigs was undertaken. Three commonly used clip models were selected: Assurance (STERIS, Mentor, Ohio, United States), Resolution (Boston Scientific, Boston, Massachusetts, United States), and SureClip (Micro-Tech, Ann Arbor, Michigan, United States). To mimic clinical practice, the following scenarios were assessed: (1) normal mucosa; (2) cold snare resection; and (3) hot mucosal resection simulating fibrotic ulcers. Deployment of clips was randomized to target sites. Repeat endoscopy was performed 2 weeks following placement. Endoscopists rated the ease of use of clip placement on a Likert scale of 1 to 5.

Results Fifty-four clips (18 Assurance, 18 Resolution, and 18 SureClip) were placed in six pigs. Mucosal healing was noted at all sites on follow up. Overall retention was nine of 18 (50.0%) SureClip, 10 of 18 (55.6%) Assurance, and 13 of 18 (72.2%) Resolution (P=0.369). There was no difference in clip retention on normal and cold snare resection sites; however, clip retention was significantly higher for Resolution clips on fibrotic ulcers (50.0% versus 0% for Assurance and 0% SureClip, P=0.03). No adverse events were reported. Ease of use was equivalent across all models.

Conclusions All clips were equivalent in efficacy and safety with successful clip deployment and mucosal healing. Overall retention rate was low for fibrotic tissue, with an improved retention rate observed with Resolution clips.

Keywords

Endoscopic resection (ESD, EMRc, ...) - Endoscopic resection (polypectomy, ESD, EMRc, ...) - Non-variceal bleeding


Publication History

Received: 16 September 2023

Accepted after revision: 17 November 2023

Accepted Manuscript online:
04 December 2023

Article published online:
08 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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