title: Endoscopic treatment of acute variceal hemorrhage by using hemostatic powder TC-325: a prospective pilot study.
abstract: BACKGROUND
  Current standard of care of acute variceal bleeding (AVB) combines hemodynamic stabilization, antibiotic prophylaxis, pharmacological agents, and endoscopic treatment. The latter may be challenging in an emergency setting with active bleeding that interferes with visualization.
  
  
  OBJECTIVE
  To assess the effectiveness of a pre-established delivery protocol of a hemostatic powder to control AVB originating from the esophagus or the gastroesophageal junction.
  
  
  METHODS
  Prospective, 2-center study.
  
  
  METHODS
  Two tertiary-care referral university hospitals.
  
  
  METHODS
  Nine patients who received endoscopic hemostatic powder for actively bleeding varices.
  
  
  METHODS
  Endoscopic hemostasis.
  
  
  METHODS
  Primary hemostasis and rebleeding rates.
  
  
  RESULTS
  Nine consecutive patients with confirmed AVB underwent treatment within 12 hours of hospital admission. Bleeding stopped during the endoscopy performed with application of 21 g of hemostatic powder from the cardia up to 15 cm above the gastroesophageal junction. No rebleeding was observed in any of the patients within 24 hours. No mortality was observed at 15-day follow-up.
  
  
  CONCLUSIONS
  Small sample size.
  
  
  CONCLUSIONS
  Hemostatic powder has the potential to temporarily stop AVB. (
  
  
  BACKGROUND
  NCT01783899.)
authors.affiliation: Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium; Department of Gastroenterology and Hepatology, Theodor Bilharz Research Institute, Cairo, Egypt.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Ibrahim
authors.forename: Ahmed
authors.initials: A
authors.lastname: El-Mikkawy
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Mostafa
authors.forename: Jacques
authors.initials: J
authors.lastname: Devière
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D016145:Endoscopy, Digestive System / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use*; D010865:Pilot Projects; D011208:Powders / Q000627:therapeutic use; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics; D008903:Minerals; D011208:Powders; C581750:hemospray
keywords: AVB; GE; acute variceal bleeding; gastroesophageal