An Expanded Role for Hemostatic Spray in Acute Variceal Bleeding?

Randomized trial data show higher hemostasis and survival rates with initial endoscopic application of hemostatic spray.

Hemostatic powders have been endoscopically applied to treat active spurting and oozing in nonvariceal bleeding in Canada, Europe, and other areas of the world. However, their application for acute variceal bleeding has been limited mainly to rescue therapy due to concerns about systemic embolization of the powder in a low-pressure venous system.

In the current study, researchers randomized 86 patients with cirrhosis and acute esophageal or gastric variceal bleeding to early elective endoscopy with or without initial endoscopic application of a hemostatic powder spray (within 2 hours of presentation). Early elective endoscopy was performed within 12 to 24 hours of admission to treat with band ligation or glue injection.

A significantly greate…

Reviewing Author

John R. Saltzman, MD

Disclosures

Consultant/Advisory BoardIterative Scopes

Editorial BoardsGastrointestinal Endoscopy; UpToDate

Leadership Positions in Professional SocietiesAmerican College of Gastroenterology (Trustee)

OtherVice President of Medical Affairs, 1Globe Health Institute