Clin Endosc.  2019 Sep;52(5):401-406. 10.5946/ce.2018.103.

Endoscopic Hemostasis for Non-Variceal Upper Gastrointestinal Bleeding: New Frontiers

Affiliations
  • 1Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA. jangs@ccf.org

Abstract

Non-variceal upper gastrointestinal bleeding (NVUGIB) refers to blood loss from the gastrointestinal tract proximal to the ligament of Treitz due to lesions that are non-variceal in origin. The distinction of the bleeding source as non-variceal is important in numerous aspects, but none more so than endoscopic approaches for successful hemostasis. When a patient presents with acute overt blood loss, NVUGIB is a medical emergency, which requires immediate intervention. There have been major strides in pharmacologic and endoscopic interventions for successful induction and remission of hemostasis in the last two decades. Despite achieving tangible improvements, the burden of the disease and the consequent mortality remain high. To address endoscopic outcomes better, several new technologies have emerged and have been subsequently incorporated to the armamentarium of hemostatic tools. This study aims to provide a succinct review on novel technologies for endoscopic hemostasis.

Keyword

Endoscopy; Hemostasis; Peptic ulcer; Gastrointestinal hemorrhage

MeSH Terms

Emergencies
Endoscopy
Gastrointestinal Hemorrhage
Gastrointestinal Tract
Hemorrhage*
Hemostasis
Hemostasis, Endoscopic*
Humans
Ligaments
Mortality
Peptic Ulcer

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Reference

1. Hearnshaw SA, Logan RF, Lowe D, Travis SP, Murphy MF, Palmer KR. Acute upper gastrointestinal bleeding in the UK: patient characteristics, diagnoses and outcomes in the 2007 UK audit. Gut. 2011; 60:1327–1335.
Article
2. Tielleman T, Bujanda D, Cryer B. Epidemiology and risk factors for upper gastrointestinal bleeding. Gastrointest Endosc Clin N Am. 2015; 25:415–428.
Article
3. Abougergi MS, Travis AC, Saltzman JR. The in-hospital mortality rate for upper GI hemorrhage has decreased over 2 decades in the United States: a nationwide analysis. Gastrointest Endosc. 2015; 81:882–888. e1.
Article
4. van Rensburg CJ, Cheer S. Pantoprazole for the treatment of peptic ulcer bleeding and prevention of rebleeding. Clin Med Insights Gastroenterol. 2012; 5:51–60.
Article
5. Laine L, Jensen DM. Management of patients with ulcer bleeding. Am J Gastroenterol. 2012; 107:345–360. quiz 361.
Article
6. Hwang JH, Fisher DA, Ben-Menachem T, et al. The role of endoscopy in the management of acute non-variceal upper GI bleeding. Gastrointest Endosc. 2012; 75:1132–1138.
Article
7. Asge Technology Committee, Conway JD, Adler DG, et al. Endoscopic hemostatic devices. Gastrointest Endosc. 2009; 69:987–996.
Article
8. Lin HJ, Hsieh YH, Tseng GY, Perng CL, Chang FY, Lee SD. A prospective, randomized trial of large- versus small-volume endoscopic injection of epinephrine for peptic ulcer bleeding. Gastrointest Endosc. 2002; 55:615–619.
Article
9. Sung JJ, Tsoi KK, Lai LH, Wu JC, Lau JY. Endoscopic clipping versus injection and thermo-coagulation in the treatment of non-variceal upper gastrointestinal bleeding: a meta-analysis. Gut. 2007; 56:1364–1373.
Article
10. Cook DJ, Guyatt GH, Salena BJ, Laine LA. Endoscopic therapy for acute nonvariceal upper gastrointestinal hemorrhage: a meta-analysis. Gastroenterology. 1992; 102:139–148.
Article
11. Sacks HS, Chalmers TC, Blum AL, Berrier J, Pagano D. Endoscopic hemostasis. An effective therapy for bleeding peptic ulcers. JAMA. 1990; 264:494–499.
Article
12. Kovacs TO, Jensen DM. Endoscopic therapy for severe ulcer bleeding. Gastrointest Endosc Clin N Am. 2011; 21:681–696.
Article
13. Hachisu T, Miyazaki S, Hamaguchi K. Endoscopic clip-marking of lesions using the newly developed HX-3L clip. Surg Endosc. 1989; 3:142–147.
Article
14. Barkun AN, Martel M, Toubouti Y, Rahme E, Bardou M. Endoscopic hemostasis in peptic ulcer bleeding for patients with high-risk lesions: a series of meta-analyses. Gastrointest Endosc. 2009; 69:786–799.
Article
15. Lin HJ, Lo WC, Cheng YC, Perng CL. Endoscopic hemoclip versus triclip placement in patients with high-risk peptic ulcer bleeding. Am J Gastroenterol. 2007; 102:539–543.
Article
16. Kirschniak A, Kratt T, Stüker D, Braun A, Schurr MO, Konigsrainer A. A new endoscopic over-the-scope clip system for treatment of lesions and bleeding in the GI tract: first clinical experiences. Gastrointest Endosc. 2007; 66:162–167.
Article
17. Naegel A, Bolz J, Zopf Y, et al. Hemodynamic efficacy of the over-the-scope clip in an established porcine cadaveric model for spurting bleeding. Gastrointest Endosc. 2012; 75:152–159.
Article
18. Manta R, Galloro G, Mangiavillano B, et al. Over-the-scope clip (OTSC) represents an effective endoscopic treatment for acute GI bleeding after failure of conventional techniques. Surg Endosc. 2013; 27:3162–3164.
Article
19. Laine L. Therapeutic endoscopy and bleeding ulcers. Bipolar/multipolar electrocoagulation. Gastrointest Endosc. 1990; 36(5 Suppl):S38–S41.
20. Wang HM, Hsu PI, Lo GH, et al. Comparison of hemostatic efficacy for argon plasma coagulation and distilled water injection in treating high-risk bleeding ulcers. J Clin Gastroenterol. 2009; 43:941–945.
Article
21. Chung SC, Leung JW, Sung JY, Lo KK, Li AK. Injection or heat probe for bleeding ulcer. Gastroenterology. 1991; 100:33–37.
Article
22. Karaman A, Baskol M, Gursoy S, et al. Epinephrine plus argon plasma or heater probe coagulation in ulcer bleeding. World J Gastroenterol. 2011; 17:4109–4112.
Article
23. Palmer R, Braden B. New and emerging endoscopic haemostasis techniques. Frontline Gastroenterol. 2015; 6:147–152.
Article
24. Arima S, Sakata Y, Ogata S, et al. Evaluation of hemostasis with soft coagulation using endoscopic hemostatic forceps in comparison with metallic hemoclips for bleeding gastric ulcers: a prospective, randomized trial. J Gastroenterol. 2010; 45:501–505.
Article
25. Nagata S, Kimura S, Ogoshi H, Hidaka T. Endoscopic hemostasis of gastric ulcer bleeding by hemostatic forceps coagulation. Dig Endosc. 2010; 22 Suppl 1:S22–S25.
Article
26. Fujishiro M, Abe N, Endo M, et al. Current managements and outcomes of peptic and artificial ulcer bleeding in Japan. Dig Endosc. 2010; 22 Suppl 1:S9–S14.
Article
27. Nunoue T, Takenaka R, Hori K, et al. A randomized trial of monopolar soft-mode coagulation versus heater probe thermocoagulation for peptic ulcer bleeding. J Clin Gastroenterol. 2015; 49:472–476.
Article
28. McGorisk T, Krishnan K, Keefer L, Komanduri S. Radiofrequency ablation for refractory gastric antral vascular ectasia (with video). Gastrointest Endosc. 2013; 78:584–588.
Article
29. Dray X, Repici A, Gonzalez P, et al. Radiofrequency ablation for the treatment of gastric antral vascular ectasia. Endoscopy. 2014; 46:963–969.
Article
30. Huang R, Pan Y, Hui N, et al. Polysaccharide hemostatic system for hemostasis management in colorectal endoscopic mucosal resection. Dig Endosc. 2014; 26:63–68.
Article
31. ASGE Technology Committee, Song WK, Banerjee SLM, et al. Emerging technologies for endoscopic hemostasis. Gastrointest Endosc. 2012; 75:933–937.
32. Chen YI, Barkun A, Nolan S. Hemostatic powder TC-325 in the management of upper and lower gastrointestinal bleeding: a two-year experience at a single institution. Endoscopy. 2015; 47:167–171.
Article
33. 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. 2014; 48:e89–e92.
34. Chen YI, Barkun AN, Soulellis C, Mayrand S, Ghali P. 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.
Article
35. 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.
Article
36. Rockall TA, Logan RF, Devlin HB, Northfield TC. Incidence of and mortality from acute upper gastrointestinal haemorrhage in the United Kingdom. Steering committee and members of the national audit of acute upper gastrointestinal haemorrhage. BMJ. 1995; 311:222–226.
37. Boonpongmanee S, Fleischer DE, Pezzullo JC, et al. The frequency of peptic ulcer as a cause of upper-GI bleeding is exaggerated. Gastrointest Endosc. 2004; 59:788–794.
Article
38. Laine L, McQuaid KR. Endoscopic therapy for bleeding ulcers: an evidence-based approach based on meta-analyses of randomized controlled trials. Clin Gastroenterol Hepatol. 2009; 7:33–47. quiz 1-2.
Article
39. Gunay K, Cabioglu N, Barbaros U, Taviloglu K, Ertekin C. Endoscopic ligation for patients with active bleeding Mallory-Weiss tears. Surg Endosc. 2001; 15:1305–1307.
Article
40. Huang SP, Wang HP, Lee YC, et al. Endoscopic hemoclip placement and epinephrine injection for Mallory-Weiss syndrome with active bleeding. Gastrointest Endosc. 2002; 55:842–846.
Article
41. Wong RM, Ota S, Katoh A, et al. Endoscopic ligation for non-esophageal variceal upper gastrointestinal hemorrhage. Endoscopy. 1998; 30:774–777.
Article
42. Norton ID, Petersen BT, Sorbi D, Balm RK, Alexander GL, Gostout CJ. Management and long-term prognosis of Dieulafoy lesion. Gastrointest Endosc. 1999; 50:762–767.
Article
43. Kwan V, Bourke MJ, Williams SJ, et al. Argon plasma coagulation in the management of symptomatic gastrointestinal vascular lesions: experience in 100 consecutive patients with long-term follow-up. Am J Gastroenterol. 2006; 101:58–63.
Article
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