Endoscopic treatment of acute variceal hemorrhage by using hemostatic powder TC-325: a prospective pilot study

BackgroundCurrent standard of care of acute variceal bleeding (AVB) combines hemodynamic stabilization, antibiotic prophylaxis, pharmacological agents, and endoscopic treatment. The latter may be challenging in an emergency setting with active bleeding that interferes with visualization.ObjectiveTo assess the effectiveness of a pre-established delivery protocol of a hemostatic powder to control AVB originating from the esophagus or the gastroesophageal junction.DesignProspective, 2-center study.SettingTwo tertiary-care referral university hospitals.PatientsNine patients who received endoscopic hemostatic powder for actively bleeding varices.InterventionsEndoscopic hemostasis.Main Outcome MeasurementPrimary hemostasis and rebleeding rates.ResultsNine consecutive patients with confirmed AVB underwent treatment within 12 hours of hospital admission. Bleeding stopped during the endoscopy performed with application of 21 g of hemostatic powder from the cardia up to 15 cm above the gastroesophageal junction. No rebleeding was observed in any of the patients within 24 hours. No mortality was observed at 15-day follow-up.LimitationsSmall sample size.ConclusionHemostatic powder has the potential to temporarily stop AVB. (Clinical trial registration number: NCT01783899.)