title: Deployment of a Short, Single-Opening Endoscopic Clip Versus a Long, Reopening Endoscopic Clip in Clinical Practice.
abstract: BACKGROUND
  Endoscopic clips vary in their designs and costs. Clip wastage is a common problem, and this is dependent on the success of its deployment.
  
  
  OBJECTIVE
  The aim of this study is to compare the rates of successful deployment between two different commonly used endoscopic clips.
  
  
  METHODS
  A single-center, retrospective study was conducted. Endoscopy reports of patients with clips deployed over 24 months were reviewed. We compared a long-pronged, reopening endoscopic clip (type A: Resolution clip; Boston Scientific, Natick, MA, USA) versus a short-pronged, single-opening clip (type B: QuickClip2; Olympus Medical Systems Corp, Japan). The main outcome was clip deployment success rate. Secondary outcomes were predictors of successful deployment, cost, and wastage.
  
  
  RESULTS
  Of 14,690 endoscopic cases, 472 clips (171 type A and 301 type B) were deployed in 262 procedures. Type A clips had a significantly higher successful deployment rate (147/171, 86.0 %) than type B clips (221/301, 73.4 %) (p = 0.002). On multivariate analysis, variables independently associated with successful deployment included using type A clips (OR 2.07, 95 % CI 1.20-3.55; p = 0.009) and clips placed in the lower gastrointestinal tract (OR 3.48, 95 % CI 1.64-7.40; p = 0.001). The cost of using type A clips was higher than type B clips (p < 0.001). Type B clips were associated with more wastage (p = 0.049).
  
  
  CONCLUSIONS
  Long-pronged, reopening clips (type A) have a better deployment rate than short-pronged, single-opening clips (type B). Although type A clips had less wastage, the cost per procedure was higher.
authors.affiliation: Division of Gastroenterology, Department of General Medicine, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore, Wee.eric.wl@alexandrahealth.com.sg.
authors.forename: Eric
authors.initials: E
authors.lastname: Wee
authors.forename: Mathew Philip
authors.initials: MP
authors.lastname: Sachin
authors.forename: Uthamanand
authors.initials: U
authors.lastname: Chinnappa
authors.forename: Su
authors.initials: S
authors.lastname: Chang
authors.forename: Cherng Hann Benjamin
authors.initials: CH
authors.lastname: Yip
mesh_terms: D003111:Colonic Polyps / Q000601:surgery*; D004724:Endoscopy / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D015999:Multivariate Analysis; D012189:Retrospective Studies
references.citation: Gastrointest Endosc. 2006 Nov;64(5):768-73
references.pmid: 17055872
references.citation: Dig Dis Sci. 2010 Jun;55(6):1726-31
references.pmid: 19657735
references.citation: Gastrointest Endosc. 1994 Mar-Apr;40(2 Pt 1):220-2
references.pmid: 8013825
references.citation: Endoscopy. 2014 May;46(5):428-31
references.pmid: 24505017
references.citation: Gastrointest Endosc. 2007 Jul;66(1):162-7
references.pmid: 17591492
references.citation: Surg Endosc. 1988;2(1):13-7
references.pmid: 3051463
references.citation: Clin Endosc. 2012 Sep;45(3):224-9
references.pmid: 22977807
references.citation: Gastrointest Endosc. 2000 Oct;52(4):566-68
references.pmid: 11023583
references.citation: Gastrointest Endosc. 2012 Jun;75(6):1132-8
references.pmid: 22624808
references.citation: Endoscopy. 2001 Aug;33(8):724-6
references.pmid: 11490392
references.citation: Gastrointest Endosc. 2009 Nov;70(5):969-75
references.pmid: 19640519
references.citation: World J Gastrointest Endosc. 2010 Oct 16;2(10):344-8
references.pmid: 21160584
references.citation: Gastrointest Endosc. 2006 May;63(6):746-50
references.pmid: 16650531
references.citation: Surg Endosc. 2013 May;27(5):1521-9
references.pmid: 23292554
references.citation: Surg Endosc. 1989;3(3):142-7
references.pmid: 2814777