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01-05-2016

First-line endoscopic treatment with OTSC in patients with high-risk non-variceal upper gastrointestinal bleeding: preliminary experience in 40 cases

Authors: Mauro Manno, Santi Mangiafico, Angelo Caruso, Carmelo Barbera, Helga Bertani, Vincenzo G. Mirante, Flavia Pigò, Khanna Amardeep, Rita Conigliaro

Published in: Surgical Endoscopy | Issue 5/2016

Abstract

Background and study aims

The over-the-scope clip (OTSC; Ovesco, Tübingen, Germany) is a novel endoscopic clipping device designed for tissue approximation. The device has been used in the closure of fistulas and perforations. We hereby report a series of patients with high-risk non-variceal upper gastrointestinal bleeding (NVUGIB) lesions in whom OTSCs were used as first-line endoscopic treatment.

Patients and methods

We prospectively collected and retrospectively analysed data over a period of 12 months from October 2013 to November 2014 from all consecutive patients who underwent emergency endoscopy for acute severe high-risk NVUGIB and were treated with OTSC as primary first-line therapy.

Results

We included forty consecutive patients with mean age 69 years (range 25–94 years). All patients were treated with the non-traumatic version of the OTSC system (23 with the 11 mm version and 17 with the 12 mm version). Indications for OTSC treatment included gastric ulcer with large vessel (Forrest IIa) (n = 8, 20 %), duodenal ulcer (Forrest Ib) (n = 7, 18 %), duodenal ulcer with large vessel (Forrest IIa) (n = 6, 15 %), Dieulafoy’s lesion (n = 6, 15 %) and other secondary indications (n = 13, 32 %). Technical success and primary haemostasis were achieved in all patients (100 %). No re-bleeding, need for surgical or radiological embolization treatment or other complications were observed during the follow-up period of 30 days.

Conclusions

We conclude OTSC placement as a first-line endoscopic treatment seems to be effective, safe and easy to perform and should be considered in patients with high-risk NVUGIB lesions.

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Title: First-line endoscopic treatment with OTSC in patients with high-risk non-variceal upper gastrointestinal bleeding: preliminary experience in 40 cases
Authors: Mauro Manno
Santi Mangiafico
Angelo Caruso
Carmelo Barbera
Helga Bertani
Vincenzo G. Mirante
Flavia Pigò
Khanna Amardeep
Rita Conigliaro
Publication date: 01-05-2016
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 5/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4436-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

First-line endoscopic treatment with OTSC in patients with high-risk non-variceal upper gastrointestinal bleeding: preliminary experience in 40 cases

Abstract

Background and study aims

Patients and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and study aims

Patients and methods

Results

Conclusions

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