PDF herunterladen
Endoscopy 2015; 47(02): 167-171
DOI: 10.1055/s-0034-1378098
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

Hemostatic powder TC-325 in the management of upper and lower gastrointestinal bleeding: a two-year experience at a single institution

Yen-I Chen
1   Division of Gastroenterology, McGill University Health Center, McGill University, Montreal, Quebec, Canada
,
Alan Barkun
1   Division of Gastroenterology, McGill University Health Center, McGill University, Montreal, Quebec, Canada
2   Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
,
Sabrina Nolan
1   Division of Gastroenterology, McGill University Health Center, McGill University, Montreal, Quebec, Canada
› Institutsangaben
Weitere Informationen

Publikationsverlauf

submitted 17. April 2014

accepted after revision 20. August 2014

Publikationsdatum:
29. September 2014 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Background and study aims: TC-325 is a novel endoscopic hemostatic powder. Our aim was to describe a single-center experience with the use of TC-325 in the upper and lower gastrointestinal tract, while for the first time attempting to determine how long the powder remains on a lesion.

Patients and methods: The charts of consecutive patients receiving TC-325 therapy between July 2011 and July 2013 were reviewed retrospectively. Primary endpoints included immediate hemostasis and early rebleeding (≤ 72 hours).

Results: Overall, 60 patients received 67 treatments with TC-325: 21 for nonmalignant nonvariceal upper gastrointestinal bleeding, 19 for malignant upper gastrointestinal bleeding, 11 for lower gastrointestinal bleeding, and 16 for intra-procedural bleeding. Immediate hemostasis was achieved in 66 cases (98.5 %), with 6 cases (9.5 %) of early rebleeding. No serious adverse events were noted. No TC-325 powder was identified in the 11 patients who underwent second-look endoscopy, performed within 24 hours in 4 patients.

Conclusions: TC-325 appears safe and effective for managing bleeding in the upper and lower gastrointestinal tract with a variety of causes. The time during which the powder remains in the gastrointestinal tract is short, with complete elimination from the gastrointestinal tract as early as within 24 hours after use.

 

  • References

  • 1 Barkun AN, Moosavi S, Martel M. Topical hemostatic agents: a systematic review with particular emphasis on endoscopic application in gastrointestinal bleeding. Gastrointest Endosc 2013; 77: 692-700
    CrossrefPubMedGoogle Scholar
  • 2 Chen YI, Barkun AN, Soulellis C et al. Use of the endoscopically applied hemostatic powder TC-325 in cancer-related upper GI hemorrhage: preliminary experience (with video). Gastrointest Endosc 2012; 75: 1278-1281
    CrossrefPubMedGoogle Scholar
  • 3 Soulellis CA, Carpentier S, Chen YI et al. Lower GI hemorrhage controlled with endoscopically applied TC-325 (with videos). Gastrointest Endosc 2013; 77: 504-507
    CrossrefPubMedGoogle Scholar
  • 4 Yau AH, Ou G, Galorport C et al. Safety and efficacy of Hemospray(R) in upper gastrointestinal bleeding. Can J Gastroenterol Hepatol 2014; 28: 72-76
    PubMedGoogle Scholar
  • 5 Sheibani S, Kim JJ, Chen B et al. Natural history of acute upper GI bleeding due to tumours: short-term success and long-term recurrence with or without endoscopic therapy. Aliment Pharmacol Ther 2013; 38: 144-150
    CrossrefPubMedGoogle Scholar
  • 6 ElOuali S, Barkun AN, Wyse J et al. Is routine second-look endoscopy effective after endoscopic hemostasis in acute peptic ulcer bleeding? A meta-analysis. Gastrointest Endosc 2012; 76: 283-292
    CrossrefPubMedGoogle Scholar
  • 7 Laine L, Spiegel B, Rostom A et al. Methodology for randomized trials of patients with nonvariceal upper gastrointestinal bleeding: recommendations from an international consensus conference. Am J Gastroenterol 2010; 105: 540-550
    CrossrefPubMedGoogle Scholar
  • 8 Smith LA, Stanley AJ, Bergman JJ et al. Hemospray application in nonvariceal upper gastrointestinal bleeding: results of the Survey to Evaluate the Application of Hemospray in the Luminal Tract. J Clin Gastroenterol 2013; [Epub ahead of print]. DOI: 10.1097/MCG.0000000000000054.
    PubMedGoogle Scholar
  • 9 Loftus EV, Alexander GL, Ahlquist DA et al. Endoscopic treatment of major bleeding from advanced gastroduodenal malignant lesions. Mayo Clin Proc 1994; 69: 736-740
    CrossrefPubMedGoogle Scholar
  • 10 Savides TJ, Jensen DM, Cohen J et al. Severe upper gastrointestinal tumor bleeding: endoscopic findings, treatment, and outcome. Endoscopy 1996; 28: 244-248
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 11 Kim YI, Choi IJ, Cho SJ et al. Outcome of endoscopic therapy for cancer bleeding in patients with unresectable gastric cancer. J Gastroenterol Hepatol 2013; 28: 1489-1495
    CrossrefPubMedGoogle Scholar
  • 12 Leblanc S, Vienne A, Dhooge M et al. Early experience with a novel hemostatic powder used to treat upper GI bleeding related to malignancies or after therapeutic interventions (with videos). Gastrointest Endosc 2013; 78: 169-175
    CrossrefPubMedGoogle Scholar
  • 13 Holster IL, Brullet E, Kuipers EJ et al. Hemospray treatment is effective for lower gastrointestinal bleeding. Endoscopy 2014; 46: 75-78
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 14 Holster IL, Kuipers EJ, Tjwa ET. Hemospray in the treatment of upper gastrointestinal hemorrhage in patients on antithrombotic therapy. Endoscopy 2013; 45: 63-66
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 15 Sung JJ, Luo D, Wu JC et al. Early clinical experience of the safety and effectiveness of Hemospray in achieving hemostasis in patients with acute peptic ulcer bleeding. Endoscopy 2011; 43: 291-295
    Google Scholar