• Mauro Manno, Santi Mangiafico, Angelo Caruso, Carmelo Barbera, Helga Bertani, Vincenzo G Mirante, Flavia Pigò, Khanna Amardeep, and Rita Conigliaro.
• Digestive Endoscopy Unit-Northern Area, Ospedale di Carpi, Azienda USL di Modena, Via G. Molinari, 2, 41012, Carpi, Italy. mauromanno@gmail.com.
• Surg Endosc. 2016 May 1; 30 (5): 2026-9.

Background And Study AimsThe over-the-scope clip (OTSC; Ovesco, Tübingen, Germany) is a novel endoscopic clipping device designed for tissue approximation. The device has been used in the closure of fistulas and perforations. We hereby report a series of patients with high-risk non-variceal upper gastrointestinal bleeding (NVUGIB) lesions in whom OTSCs were used as first-line endoscopic treatment.Patients And MethodsWe prospectively collected and retrospectively analysed data over a period of 12 months from October 2013 to November 2014 from all consecutive patients who underwent emergency endoscopy for acute severe high-risk NVUGIB and were treated with OTSC as primary first-line therapy.ResultsWe included forty consecutive patients with mean age 69 years (range 25-94 years). All patients were treated with the non-traumatic version of the OTSC system (23 with the 11 mm version and 17 with the 12 mm version). Indications for OTSC treatment included gastric ulcer with large vessel (Forrest IIa) (n = 8, 20 %), duodenal ulcer (Forrest Ib) (n = 7, 18 %), duodenal ulcer with large vessel (Forrest IIa) (n = 6, 15 %), Dieulafoy's lesion (n = 6, 15 %) and other secondary indications (n = 13, 32 %). Technical success and primary haemostasis were achieved in all patients (100 %). No re-bleeding, need for surgical or radiological embolization treatment or other complications were observed during the follow-up period of 30 days.ConclusionsWe conclude OTSC placement as a first-line endoscopic treatment seems to be effective, safe and easy to perform and should be considered in patients with high-risk NVUGIB lesions.

25 keywords...

hide…