Wander P, et al. - This study incorporated an investigation of the safety and efficacy of the Instinct clip in the acute endoscopic treatment of upper gastrointestinal bleeding (UGIB). FIndings disclosed that the Instinct clip, when used for UGIB, was safe and effective. It displayed similar rebleeding rates compared with other modalities.

Methods

• In this large series, researchers reported the use of Instinct clip in achieving hemostasis.
• The scheme of this study was a retrospective descriptive chart review.
• It included patients presenting with recent overt GI bleeding treated with endoclip therapy at Mount Sinai Beth Israel Medical Center between May 2013 and January 2016.
• Findings were expressed in absolute numbers, percentages, and trends.

Results

• A total of 178 consecutive patients with UGIB were analyzed.
• It was determined that the source of bleeding was duodenal ulcer (29.2%), gastric ulcer (22.5%), gastro-esophageal junction tear (8.4%), anastomosis (5.6%), erosive gastropathy (5.6%), Dieulafoy (5.1%), gastric polyp (4.5%), postendoscopic procedure (3.9%), angioectasia (3.4%), esophageal ulcer (2.8%), benign duodenal mass (2.8%), peg tube site (2.3%), gastric neoplasm (1.7%), esophagitis (1.1%), and small bowel ulcer (1.1%).
• Active bleeding was illustrated in the lesions in 47.5% cases (11.3% spurting and 36.2% oozing) and nonbleeding lesions in 52.5% (25.0% visible vessel, 11.9% hematin in ulcer base, 10.0% adherent clot, 5.6% flat spot).
• As per the results, initial hemostasis was achieved in 96.6%.
• In 24.1% cases, the use of additional methods was noted (argon plasma coagulation and epinephrine injection in 21.3%, surgery in 0.6%, and interventional radiology in 2.2%).
• No adverse events were reported.
• Data demonstrated that the in-hospital rebleeding was 7.3% and 3.9% presented with rebleeding within 30 days.
• It was discovered that the average procedure duration was 22.9 minutes and average length of hospital stay was 11.3 days.