PMID- 29124127
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240327
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 5
IP  - 11
DP  - 2017 Nov
TI  - Effectiveness of TC-325 (Hemospray) for treatment of diffuse or refractory upper 
      gastrointestinal bleeding - a single center experience.
PG  - E1159-E1164
LID - 10.1055/s-0043-118794 [doi]
AB  - BACKGROUND AND STUDY AIMS:  TC-325 (Hemospray, Cook Medical) is a powder agent 
      for endoscopic hemostasis in patients with upper gastrointestinal bleeding 
      (UGIB). Although most publications are based on case-reports and retrospective 
      studies, data on efficacy are promising. Here we report our experience with 
      TC-325 for diffuse or refractory UGIB. PATIENTS AND METHODS:  Data on patients 
      receiving TC-325 for endoscopic hemostasis from November 2013 to February 2017 at 
      our center were analyzed retrospectively. Primary endpoints were technical 
      success (successful immediate hemostasis) and clinical success (effective 
      hemostasis and no recurrent bleeding). Secondary endpoints were recurrent 
      bleeding within 3 and 7 days, hospital mortality and TC-325 associated 
      complications. TC-325 was used for bleeding not amenable to standard endoscopic 
      treatment (e. g. diffuse bleeding) or as salvage therapy after failure of 
      conventional methods. RESULTS:  Fifty-two patients received TC-325 treatment. 
      Most of the patients were treated for peptic ulcer bleeding (18/52 patients, 
      34.6 %) and post-interventional bleeding (13/52 patients, 25 %). Hemospray was 
      used in 23/52 (44.2 %) patients as monotherapy and in 29/52 (55.8 %) patients as 
      a salvage therapy. Application of the powder on the bleeding source was 
      successful in all patients with no therapy-related adverse events (AEs). 
      Immediate hemostasis was achieved in 51/52 (98.1 %) patients. Recurrent bleeding 
      within 3 and 7 days was observed in 22/51 and 25/51 patients respectively (43.1 % 
      and 49 %). The overall clinical success was 56.9 % on day 3 and 51 % on day 7. 
      Total mortality was 15.4 % (8 patients), bleeding associated mortality was 3.8 % 
      (2 patients). There were no therapy-related AEs. CONCLUSIONS:  TC-325 showed a 
      high technical success rate as monotherapy for bleeding sources not amenable to 
      standard methods or as an "add-on" therapy after unsuccessful hemostasis. 
      However, rebleeding was frequent in this cohort and further studies are warranted 
      to exactly define a treatment algorithm for TC-325 use.
FAU - Cahyadi, Oscar
AU  - Cahyadi O
AD  - Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Ludwigsburg, 
      Germany.
FAU - Bauder, Markus
AU  - Bauder M
AD  - Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Ludwigsburg, 
      Germany.
FAU - Meier, Benjamin
AU  - Meier B
AD  - Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Ludwigsburg, 
      Germany.
FAU - Caca, Karel
AU  - Caca K
AD  - Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Ludwigsburg, 
      Germany.
FAU - Schmidt, Arthur
AU  - Schmidt A
AD  - Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Ludwigsburg, 
      Germany.
AD  - Department of Medicine II, Medical Center - University of Freiburg, Faculty of 
      Medicine, University of Freiburg, Germany.
LA  - eng
PT  - Journal Article
DEP - 20171108
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC5677459
COIS- Competing interests None
EDAT- 2017/11/11 06:00
MHDA- 2017/11/11 06:01
PMCR- 2017/11/01
CRDT- 2017/11/11 06:00
PHST- 2017/05/14 00:00 [received]
PHST- 2017/07/24 00:00 [accepted]
PHST- 2017/11/11 06:00 [entrez]
PHST- 2017/11/11 06:00 [pubmed]
PHST- 2017/11/11 06:01 [medline]
PHST- 2017/11/01 00:00 [pmc-release]
AID - 10.1055/s-0043-118794 [doi]
PST - ppublish
SO  - Endosc Int Open. 2017 Nov;5(11):E1159-E1164. doi: 10.1055/s-0043-118794. Epub 
      2017 Nov 8.