title: Hemospray in the treatment of upper gastrointestinal hemorrhage in patients on antithrombotic therapy.
abstract: Patients on antithrombotic therapy (ATT) have the highest risk of ongoing bleeding and mortality. Hemospray (Cook Medical, Winston-Salem, North Carolina, USA) is a novel hemostatic agent for the treatment of upper gastrointestinal bleeding (UGIB). Initial reports on its use appear promising in terms of initial hemostasis and rebleeding rates. It is unknown whether this also pertains to patients on ATT. The aim of the current study therefore was to evaluate the efficacy of Hemospray in the treatment of UGIB in patients taking ATTs. A total of 16 unselected consecutive patients with UGIB who were treated with Hemospray were analyzed (eight taking ATT for various indications and eight not on ATT). Initial hemostasis was achieved after Hemospray application in 5 /8 patients on ATT (63 %) and in all eight patients not on therapy (P = 0.20). Rebleeding rates were similar in both groups. These preliminary data on the use of Hemospray in the management of UGIB are promising in both patients with and without ATT; however, caution should be exercised for its use in patients on ATT with spurting arterial bleeding.
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands. i.holster@erasmusmc.nl
authors.forename: I L
authors.initials: IL
authors.lastname: Holster
authors.forename: E J
authors.initials: EJ
authors.lastname: Kuipers
authors.forename: E T T L
authors.initials: ET
authors.lastname: Tjwa
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D016558:Hemostasis, Endoscopic; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000008:administration & dosage*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011208:Powders / Q000008:administration & dosage; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D006490:Hemostatics; D008903:Minerals; D010975:Platelet Aggregation Inhibitors; D011208:Powders; C581750:hemospray