title: EndoClot Polysaccharide Hemostatic System in Nonvariceal Gastrointestinal Bleeding: Results of a Prospective Multicenter Observational Pilot Study.
abstract: Hemostatic powders have been introduced to improve the management of gastrointestinal (GI) bleeding and to extend the variety of tools available for emergency endoscopy. The aim of the present pilot study was to evaluate the indication profiles and the short-term outcome of EndoClot.
  
  
  
  In a prospective observational pilot study patients with acute nonvariceal GI bleeding were included. Primary or secondary application of EndoClot was assessed. Hemoglobin, prothrombine time and platelets were documented before and after hemostasis. The efficacy of EndoClot was assessed 72 hours and 1 week after application.
  
  
  
  Seventy patients with acute GI bleeding were recruited into the study. Eighty-three percent (58/70) of the patients had upper and 17% (12/70) had lower GI bleeding. In the upper GI tract treatment success was achieved in 64% (30/47, 95% confidence interval, 50%-76%) after primary use and in all patients, when used after established techniques had failed (95% confidence interval, 70%-100%). In lower GI bleeding hemostasis was achieved in 83% of cases (10/12, 95% confidence interval 54%-97%). Rebleeding occurred in 11% (8/70), in 10% EndoClot served as a bridge to surgery (7/70).
  
  
  
  EndoClot expanded the therapeutic options in the management of GI bleeding. It was applicable as a monotherapy or in combination with other techniques from oozing bleeding type or lower. It was most effective in diffuse or extensive bleeding activity or when access to the bleeding vessel was difficult. EndoClot can be applied as a bridge to surgery when classical methods of hemostasis have failed.
authors.affiliation: *Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Med. Dept. of Gastroenterology, Infectious Diseases and Rheumatology †Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin ‡Campus Virchow Klinikum, Med. Dept. of Gastroenterology and Hematology, Charité - Universitätsmedizin Berlin §Campus Mitte, Med. Dept. for Gastroenterology and Hematology ∥Sana Hospital Lichtenberg, Department of Internal Medicine I: Gastroenterology #Evangelisches Waldkrankenhaus Spandau, Department of Internal Medicine I, Berlin ¶University Hospital Münster, Med. Dept. B, Münster, Germany.
authors.forename: Jan C
authors.initials: JC
authors.lastname: Prei
authors.forename: Christian
authors.initials: C
authors.lastname: Barmeyer
authors.forename: Nataly
authors.initials: N
authors.lastname: Bürgel
authors.forename: Severin
authors.initials: S
authors.lastname: Daum
authors.forename: Hans-Jörg
authors.initials: HJ
authors.lastname: Epple
authors.forename: Ute
authors.initials: U
authors.lastname: Günther
authors.forename: Jochen
authors.initials: J
authors.lastname: Maul
authors.forename: Britta
authors.initials: B
authors.lastname: Siegmund
authors.forename: Michael
authors.initials: M
authors.lastname: Schumann
authors.forename: Hanno
authors.initials: H
authors.lastname: Tröger
authors.forename: Andrea
authors.initials: A
authors.lastname: Stroux
authors.forename: Andreas
authors.initials: A
authors.lastname: Adler
authors.forename: Winfried
authors.initials: W
authors.lastname: Veltzke-Schlieker
authors.forename: Christian
authors.initials: C
authors.lastname: Jürgensen
authors.forename: Robert
authors.initials: R
authors.lastname: Wentrup
authors.forename: Bertram
authors.initials: B
authors.lastname: Wiedenmann
authors.forename: Jana
authors.initials: J
authors.lastname: Binkau
authors.forename: Dirk
authors.initials: D
authors.lastname: Hartmann
authors.forename: Ellen
authors.initials: E
authors.lastname: Nötzel
authors.forename: Dirk
authors.initials: D
authors.lastname: Domagk
authors.forename: Wolfram
authors.initials: W
authors.lastname: Wacke
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wahnschaffe
authors.forename: Christian
authors.initials: C
authors.lastname: Bojarski
mesh_terms: D000368:Aged; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D005858:Germany; D016558:Hemostasis, Endoscopic; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011134:Polysaccharides / Q000008:administration & dosage*; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D011134:Polysaccharides