New and emerging technologies to endoscopically manage nonvariceal upper gastrointestinal bleeding

A subset of patients with nonvariceal upper gastrointestinal bleeding either fails or is deemed unsuitable for standard endoscopic hemostatic therapy. Newer endoscopic and endosonographic techniques have been developed to offer an alternative treatment and potentially improve patient outcome for the difficult-to-treat lesions. These alternative therapies include over-the-scope clip devices, radiofrequency ablation, cryotherapy, hemostatic sprays, endoscopic suturing, and endoscopic ultrasound-guided angiotherapy. This article serves to review these novel techniques that can be incorporated in the armamentarium to treat nonvariceal upper gastrointestinal bleeding.