Endoscopic application of polysaccharide powder for hemostasis in anticoagulated pigs (with video).

ABSTRACT

BACKGROUND: Acute GI bleeding remains a clinical problem of daily importance. Increasing numbers of patients with compromised coagulation challenge the established methods of endoscopic hemostasis. Therefore, new powders for the treatment of GI bleeding have been developed. OBJECTIVE: To clarify the efficacy of a newly available anticoagulant powder in stopping hemorrhage. DESIGN: A randomized prospective comparative study regarding the potential of an endoscopically applicable polysaccharide powder in pigs receiving antithrombotic medication. SETTING: A professional veterinary animal laboratory. PATIENTS Twenty-two pigs were anticoagulated with heparin (n = 8), aspirin (n = 8), or no antithrombotic medication (n = 6), in a randomized order. INTERVENTIONS: A bleeding ulcer with continuous bleeding (Forrest I b) was established in the stomach. Endoscopic hemostasis was performed using the powder. MAIN OUTCOME MEASUREMENTS Time to hemostasis and the amount of powder used were recorded. Follow-up occurred for 3 days, final hemoglobin measurement, followed by autopsy with control for post-interventional bleeding. RESULTS: Endoscopic hemostasis was successful in all cases. Post-interventional bleeding was not recorded. LIMITATIONS: Animal study, artificial superficial bleeding source. CONCLUSION: Polysaccharide powder is able to stop active bleeding from Forrest I b lesions in pigs receiving antithrombotic therapy.