title: The Application of Hemospray in Gastrointestinal Bleeding during Emergency Endoscopy.
abstract: Introduction. Gastrointestinal bleeding represents the main indication for emergency endoscopy (EE). Lately, several hemostatic powders have been released to facilitate EE.Methods. We evaluated all EE in which Hemospray was used as primary or salvage therapy, with regard to short- and long-term hemostasis and complications.Results. We conducted 677 EE in 474 patients (488 examinations in 344 patients were upper GI endoscopies). Hemospray was applied during 35 examinations in 27 patients (19 males), 33 during upper and 2 during lower endoscopy. It was used after previous treatment in 21 examinations (60%) and in 14 (40%) as salvage therapy. Short-term success was reached in 34 of 35 applications (97.1%), while long-term success occurred in 23 applications (65.7%). Similar long-term results were found after primary application (64,3%) or salvage therapy (66,7%). Rebleeding was found in malignant and extended ulcers. One major adverse event (2.8%) occurred with gastric perforation after Hemospray application.Discussion. Hemospray achieved short-term hemostasis in virtually all cases. The long-term effect is mainly determined by the type of bleeding source, but not whether it was applied as first line or salvage therapy. But, even in the failures, patients had benefit from hemodynamic stabilization and consecutive interventions in optimized conditions.
authors.affiliation: Department of Gastroenterology, University of Erlangen, Ulmenweg 18, 91054 Erlangen, Germany.
authors.forename: Alexander F
authors.identifier: 0000-0002-1785-0488
authors.initials: AF
authors.lastname: Hagel
authors.affiliation: Department of Gastroenterology, University of Erlangen, Ulmenweg 18, 91054 Erlangen, Germany.
authors.forename: Heinz
authors.initials: H
authors.lastname: Albrecht
authors.affiliation: Department of Gastroenterology, University of Erlangen, Ulmenweg 18, 91054 Erlangen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Nägel
authors.affiliation: Department of Gastroenterology, University of Erlangen, Ulmenweg 18, 91054 Erlangen, Germany.
authors.forename: Francesco
authors.initials: F
authors.lastname: Vitali
authors.affiliation: Department of Gastroenterology, University of Erlangen, Ulmenweg 18, 91054 Erlangen, Germany.
authors.forename: Marcel
authors.initials: M
authors.lastname: Vetter
authors.affiliation: Institute for Employment Research, Regensburger Straße 104, 90478 Nuremberg, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Dauth
authors.affiliation: Department of Gastroenterology, University of Erlangen, Ulmenweg 18, 91054 Erlangen, Germany.
authors.forename: Markus F
authors.initials: MF
authors.lastname: Neurath
authors.affiliation: Department of Gastroenterology, Waldkrankenhaus St. Marien, Rathsberger Str. 57, 91054 Erlangen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Raithel