Treatment of gastrointestinal bleeding with hemostatic powder (TC-325): a multicenter study
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Hemostatic powder (TC-325) is a new tool for treatment of gastrointestinal bleeding that allows the treatment of large surfaces with active bleeding. The aim was to describe the initial success of TC-325 for the control of GI bleeding.
Materials and methods
We did a multicenter cohort study with patients admitted to the endoscopy service for GI bleeding. A format was generated to standardize the information obtained in each center. It was determined whether this treatment had been used as a single therapy or as a combination therapy. Descriptive statistics with medians and ranges, or averages with SD according to distribution.
Eighty-one patients with 104 endoscopic procedures were included. The median number of endoscopic procedures was 1 (1–3). In the first procedure, the initial success rate was 98.8% (n = 80), failure rate was 1.2% (n = 1), and rebleeding rate was 20% (n = 16). The majority of rebleeding cases occurred within the first 3 days (12/16, 75%). There was no association between rebleeding and etiology (malignant or benign; P = 0.6). In first procedure, 44 (54%) cases had monotherapy with TC-325 and 37 (46%) cases had a combined endoscopic therapy. There were no differences in initial success or rebleeding rates when TC-325 was used as monotherapy versus combined therapy (P = 0.7). The mortality rate was 4% (3/81).
TC-325 is effective for achieving initial control of bleeding in patients with different GI etiologies. The rate of bleeding recurrence is considerable in both patients with benign and malignant etiology.
KeywordsHemostatic powder TC-325 Active bleeding Gastrointestinal bleeding Mexico
Compliance with ethical standards
Drs. Ariadna Iraís Ramírez-Polo, Jorge Casal-Sánchez, Angélica Hernández-Guerrero, Luz María Castro-Reyes, Melissa Yáñez-Cruz, Louis Francois De Giau-Triulzi, Javier Vinageras-Barroso, Félix Ignacio Téllez-Ávila have no conflict of interest or financial ties to disclose.
Supplementary material 1 Video 1. Example of the technique used to apply TC-325. In this case, a patient with Dieulafoy’s lesion and severe thrombocytopenia, TC-325 was included as a combination therapy after hemoclip application. (MP4 92679 KB)
Supplementary material 2 Video 2. Example of the technique used to apply TC-325. In this case, a patient with variceal bleeding after treatment with band ligation of esophageal varices, TC-325 was used as an adjuvant therapy to achieve control of bleeding. (MP4 120110 KB)
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