Editor’s Choice: The use of hemostatic spray as an adjunct to conventional hemostatic measures

Wallace_headshotEditor-in-Chief Mike Wallace, MD, MPH, highlights this article from the December issue “The use of hemostatic spray as an adjunct to conventional hemostatic measures in high-risk nonvariceal upper GI bleeding (with video)” by Ryota Niikura, MD, PhD, Hideo Yasunaga, MD, PhD, Atsuo Yamada, MD, PhD, Hiroki Matsui, PhD, Kiyohide Fushimi, MD, PhD, Yoshihiro Hirata, MD, PhD, Kazuhiko Koike, MD, PhD.

Background and Aims: Endoscopic management of nonvariceal upper GI bleed (NVUGIB) can be challenging. Hemospray is a novel endoscopic hemostatic agent for NVUGIB. Its efficacy in attaining hemostasis in NVUGIB is promising, particularly with respect to technically difficult lesions. However, most of the currently available data are focused on its application as monotherapy. The aim of this study was to evaluate its efficacy as a second agent to adrenaline, or as an addition to the combination of adrenaline with either clips or a thermal device in NVUGIB.

Editor's Choice_figure
Figure 1: Forrest 1a duodenal ulcer.

The current standard of care for nonvariceal upper GI bleeding is duel therapy, typically epinephrine plus coagulation or clipping. Coagulation and clipping require more precise localization and skill to perform. Hemostatic spray is a convenient therapy that does not require precise localization and has been used effectively outside of the United States.

The current study provides additional evidence that hemostatic spray may be as effective as dual or triple therapy when epinephrine alone or in combination with thermal or clipping therapy fail.

Read the article abstract here.

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