Clin Endosc.  2019 Nov;52(6):574-580. 10.5946/ce.2019.122.

Endoscopic Management with a Novel Over-The-Scope Padlock Clip System

• Goenka MK
• Rodge GA
• Tiwary IK

• KMID: 2465800
• DOI: http://doi.org/10.5946/ce.2019.122

Abstract

BACKGROUND/AIMS
The Padlock clip is a recently introduced over-the-scope clip (OTSC) that requires the use of an alternate technique and has a different design from previous OTSCs. However, data regarding its clinical use are limited. The aim of this study is to present our clinical experience using this novel Padlock clip system.
METHODS
Between September 2018 and June 2019, 7 consecutive patients underwent Padlock clip application at our center by an experienced endoscopist. A Padlock clip was used for achieving hemostasis in 4 patients presenting with gastrointestinal (GI) bleeding, as well as for endoscopic full-thickness resection in the remaining 3 patients.
RESULTS
All 7 patients achieved technical as well as clinical success, with absence of complications or rebleeding, during a follow-up of a minimum of 3 weeks. All patients were hospitalized post procedure for a minimum of 48 hours, and an absence of adverse events was noted in our patient population throughout the procedure and post-procedure period. Antiplatelet therapy was reinstated shortly after the application of the Padlock clip, with no GI bleeding observed.
CONCLUSIONS
The Padlock clip is a novel OTSC, with benefits that include safe, simple, and rapid deployment. Antiplatelet therapy may be reinstated for patients, when necessary, shortly after applying the Padlock clip due to full-thickness closure of the tissue.

Keyword

Endoscopic management; Gastrointestinal hemorrhages; Novel over-the-scope clip; Over-the-scope clip; Padlock

MeSH Terms

Follow-Up Studies
Gastrointestinal Hemorrhage
Hemorrhage
Hemostasis
Humans

Figure

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  Fig. 1. (A) Padlock clip (Aponos Medical Co., Kingston, NH, USA) and its parts. (B) Preassembled Padlock clip.

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  Fig. 2. (A) Angiodysplasia in stomach with discharge. (B) Padlock clip (Aponos Medical Co., Kingston, NH, USA) applied near bleeding point.

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  Fig. 3. (A) Large duodenal ulcer observed at first part of duodenum. (B) Padlock clip (Aponos Medical Co., Kingston, NH, USA) applied at the ulcer site.

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  Fig. 4. (A) Discharge from the gastric ulcer. (B) Padlock clip (Aponos Medical Co., Kingston, NH, USA) applied and hemostasis achieved.

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  Fig. 5. (A) Gastric neuroendocrine tumor. (B) Padlock clip (Aponos Medical Co., Kingston, NH, USA) surrounding the nodule.

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  Fig. 6. (A) Duodenal neuroendocrine tumor. (B) Duodenal neuroendocrine tumor after Padlock clip (Aponos Medical Co., Kingston, NH, USA) application.

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  Fig. 7. (A) Rectal Polyp. (B) Padlock clip (Aponos Medical Co., Kingston, NH, USA) surrounding the polyp.

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  Fig. 8. (A) Ovesco clip (Tübingen, Germany). (B) Padlock clip (Aponos Medical Co., Kingston, NH, USA).

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