Endoscopic application of polysaccharide powder for hemostasis in anticoagulated pigs (with video).
BACKGROUND
Acute GI bleeding remains a clinical problem of daily importance. Increasing numbers of patients with compromised coagulation challenge the established methods of endoscopic hemostasis. Therefore, new powders for the treatment of GI bleeding have been developed.


OBJECTIVE
To clarify the efficacy of a newly available anticoagulant powder in stopping hemorrhage.


METHODS
A randomized prospective comparative study regarding the potential of an endoscopically applicable polysaccharide powder in pigs receiving antithrombotic medication.


METHODS
A professional veterinary animal laboratory.


METHODS
Twenty-two pigs were anticoagulated with heparin (n = 8), aspirin (n = 8), or no antithrombotic medication (n = 6), in a randomized order.


METHODS
A bleeding ulcer with continuous bleeding (Forrest I b) was established in the stomach. Endoscopic hemostasis was performed using the powder.


METHODS
Time to hemostasis and the amount of powder used were recorded. Follow-up occurred for 3 days, final hemoglobin measurement, followed by autopsy with control for post-interventional bleeding.


RESULTS
Endoscopic hemostasis was successful in all cases. Post-interventional bleeding was not recorded.


CONCLUSIONS
Animal study, artificial superficial bleeding source.


CONCLUSIONS
Polysaccharide powder is able to stop active bleeding from Forrest I b lesions in pigs receiving antithrombotic therapy.
Central Interdisciplinary Endoscopy, Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.
Georg
G
Kaehler
Central Interdisciplinary Endoscopy, Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.
Christina
C
Dutenhoefner
Central Interdisciplinary Endoscopy, Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.
Richard
R
Magdeburg
D000818:Animals; D000925:Anticoagulants / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006490:Hemostatics / Q000627:therapeutic use*; D006493:Heparin / Q000009:adverse effects; D010438:Peptic Ulcer Hemorrhage / Q000139:chemically induced / Q000628:therapy*; D011134:Polysaccharides / Q000627:therapeutic use*; D011208:Powders; D011446:Prospective Studies; D011897:Random Allocation; D013276:Stomach Ulcer / Q000150:complications*; D013552:Swine; D016896:Treatment Outcome
D000925:Anticoagulants; D006490:Hemostatics; D011134:Polysaccharides; D011208:Powders; D006493:Heparin; D001241:Aspirin