Table 1.
Summary of reports on the use of Hemospray for endoscopic hemostasis in humans.
| Study | Mean Age (yrs) | Sample size | Sex | Location of bleed | Lesion size (mm) | Source of bleeding | Forrest Classification | Prior treatment | Delivery device | Subsequent treatments | Number of applications | Successful hemostasis | Rebleeding | Mortality 30 days |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Sung et al. [2011], Hong Kong | 60.2 | 20 | 18M 2F |
Stomach (6/20) Duodenum (14/20) |
NR | Arterial | 1a (1) 1b (19) |
None | 21g of Hemospray catheter and introducer with CO2 canister | None | 1=13/20 2=5/20 >2=2/20 |
19/20 [95%] | 1/20 | None |
| Chen et al. [2012], Canada | 74 69 58 49 53 |
1 1 1 1 1 |
F M F F F |
Gastric Antrum Distal esophagus Duodenal bulb Duodenal flexure Gastric cardia |
Large Large 58×36×39 NR NR |
Gastric adenoCA AdenoCA AdenoCA pancreatic head Breast CA Non-small cell lung CA |
N/A | None None None None Epi and APC |
20 g of Hemospray powder in canister 15 g of Hemospray powder in canister 20g of Hemospray powder in canister 20g of Hemospray powder in canister 20g of Hemospray powder in canister |
None None None None None |
1 1 1 1 2 |
1/1 [100%] 1/1 [100%] 1/1 [100%] 1/1 [100%] 1/1 [100%] |
0/1 0/1 0/1 0/10/1 |
None None None None None |
| Fujita [2012], Japan | 79 | 1 | F | Gastric fundus | 8 | Gastric varices | N/A | Lipiodol injection | 10g of Hemospray powder in canister | None | 1 | 1/1 [100%] | 0/1 | None |
| Granata et al. [2013], Italy | 51 | 1 | NR | Cecum | 30 | NR | N/A | Fibrin glue injection | Hemospray powder in canister | None | 2 | 1/1 [100%] | 0/1 | None |
| Leblanc et al. [2013], France | 67 71 59.7 60.9 |
1 1 3 7 |
M M 2M 1F 5M 2F |
Proximal esophagusGastric cardia Distal esophagus Duodenum |
12 25 23 38.1 |
SCC Intestinal metaplasia with LGD and HGD AdenoCA, and Barrett’s esophagus Tubulovillous adenoma with LGD |
N/A | None None None None |
20 g of Hemospray powder in canister 20 g of Hemospray powder in canister 20 g of Hemospray powder in canister20 g of Hemospray powder in canister |
None None None None |
1 1 1 1 |
1/1 [100%] 1/1 [100%] 3/3 [100%] 7/7 [100%] |
0/1 0/1 0/3 0/7 |
None None None None |
| Ibrahim et al. [2013], Egypt | 61.7 | 9 | 7M 2F | Esophagus and GE junction | NR | Esophageal varices | N/A | None | 21g of Hemospray powder in canister | None | 8/9 (1) 1/9 (2) |
9/9 [100%] | 0/9 | None |
| Smith et al. [2013], UK | 69.8 66 |
3 1 |
2M 1F F |
Antrum Proximal stomach |
NR NR |
PHG PHG |
N/A | APC (1) None |
20g of Hemospray powder in canister 20g of Hemospray powder in canister |
None None |
1 1 |
3/3[100%] 1/1 [100%] |
0/3 0/1 |
None None |
| Sargon and Laurie [2013], United States | 13 | 1 | M | Duodenum | NR | Duodenal ulcer | 1b | Embolization therapy | 25 – 30 g of Hemospray powder in canister | None | 1 | 1/1 [100%] | 0/1 | None |
| Stanley et al. [2013], UK | 37 | 1 | M | Gastric | Large | Gastric varices | N/A | Histoacryl and Lipiodol injections | Hemospray powder in canister | TIPS | 1 | 1/1 [100%] | 0/1 | None |
| Soulellis et al. [2013], Canada | 79 56 82 69 |
1 1 1 1 |
M M M M |
Cecum Recto sigmoid Lower GI tract Rectum |
30 10 350 70 |
Sessile polyp (post-snare cautery, clip) Tubular adenoma; HGD Dieulafoy lesion Radiation proctitis |
N/A | Metal clips Epi, thermal probe, clip 5 metal clips, Epi APC |
20 g of Hemospray powder in canister 30 g of Hemospray powder in canister 20 g of Hemospray in canister 20 g of Hemospray in canister |
None None None None |
1 1 1 1 |
1/1 [100%] 1/1 [100%] 1/1 [100%] 1/1 [100%] |
0/1 0/1 0/1 0/1 |
None None None None |
| Yau et al. [2014], Canada | 67.6 | 19 | 14M 5F |
Esophagus (1/19) Stomach (5/19) Duodenum (13/19) |
NR | Peptic ulcer (12/19) Dieulafoy lesion (2/19) Mucosal erosion (1/19) Angiodysplasia (1/19) Ampullectomy (1/19) Polypectomy (1/19) Unidentified (1/19) |
1a (4) | Epi (16/19) Thermal probe (10/19) Clips, bands (9/19) Transarterial embolization (2/19) Surgical oversewing (1/19) |
20 g of Hemospray powder in canister | 1/19 | 1 | 18/19 [94.7%] | 7/18 [38.9%] | 5/19 [26.3%] |
| Smith et al. [2013], UK SEAL survey | 69 | 63 | 44M 19F |
Esophagus, Stomach, Duodenum (63) | NR | Gastric ulcers (14/63) Duodenal ulcers (16/63) Post-EMR (7/63) Tumor (5/63) Esophageal ulcer (3/63) Dieulafoy (2/63) GAVE (2/63) Gastritis (2/63) Mallory Weiss (2/63) Sphincterotomy (1/63) Esophagitis (1/63) GIST (1/63) Ampullectomy (1/63) Duodenal diverticulum (1/63) Aortoduodenal fistula (1/63) Duodenal erosions (1/63) Post-HALO® (1/63) Duodenal polyp (1/63) Diffuse duodenal bleeding unknown cause (1/63) |
1a (11) 1b (16) |
Monotherapy (55/63) Second-line therapy (8/63) |
20 g of Hemospray powder in canister | Angiographic embolization (1/8) Bipolar probe, epi (1/8) Clip, Epi, Surgery (1/8) Clip (1/8) Epi, heater probe (1/8) Heater probe, clip |
1 | 47/55 [85%] |
7/47 [15%] | 3/55 [5%] |
| Holster et al. [2014], Spain and Netherlands | 63 | 9 | 5M 4F |
Cecum Ascending colon Transverse colon Rectum |
NR | Colorectal anastomosis (1/9) Rectal ulcer 1/9) Colonic diverticulum (1/9) Cecal adenoCA (1/9) Proctitis (1/9) Polypectomy (4/9): rectum (2), transverse colon (1), ascending colon (1) |
N/A | Monotherapy (6/9) Clips and/or Epi (3/9) |
20 g of Hemospray powder in canister, 10 Fr catheter | None | 1 | 7/9 [77.8%] | 2/9 [22.2%] | None |
| Sulz et al. [2014], Switzerland | 67 | 16 | 13M 3F |
Esophagus (2/16) Stomach (5/16) Duodenum(4/14) Papilla of Vater (2/16) Jejunum (2/16) Anus (1/16) |
NR | Duodenal ulcer Sphincterotomy papilla of vater Esophagus PHG: cardia Gastro-esophageal anastomosis Jejunal Dieulafoy Duodenal ulcer Metastatic gastric melanoma Gastric varices Jejunal tumor ulceration Recurrent anal carcinoma Buried bumper after incision, stomach |
1b (4) N/A (12) |
Monotherapy (2/16) Salvage therapy (14/16) Injection Clip Heater probe APC |
20 g of Hemospray powder in canister, 10 Fr catheter |
Angiographic embolization Surgery |
1 | 15/16 [93.8%] Monotherapy 2/2 [100%] Salvage therapy 13/14 [92.85%] |
2/16 [12.5%] | None |
| Paganelli et al. [2014], Canada | 0.91 | 1 | F | Esophagus | NR | Esophageal ulcer | N/A | Sclerosing agent injection | Hemospray | None | 1 | 1/1 [100%] | 0/1 | None |
| Chen et al. [2014], Canada | NR | 67 | 43 M 24 F |
NVUGIB (21/67) Malignant UGIB (19/67) LGIB (11/67) Intra-procedural bleeding (16/67) |
NR | NR | 1a (3) 1b (10) Remaining N/A |
None | Hemospray | None | 1 | 20/21 [95.2%] 19/19 [100%] 11/11 [100%] 16/16 [100%] |
8/17 [47%] 6/19 [31.6%] 0/11 0/16 |
None 4/19 [21.1%] None None |
| Moosavi et al. [2013], Canada | NR | 1 | NR | Duodenum | NR | Sphincterotomy | N/A | None | 5 g of Hemospray powder in canister | None | 1 | 1/1 [100%] | 0/1 | None |
AdenoCA, adenocarcinoma; APC, argon plasma coagulation; SCC, squamous cell carcinoma; LGD, low-grade dysplasia; HGD, high-grade dysplasia; N/A, not applicable; NR, not reported; EMR, endoscopic mucosal resection; Epi, epinephrine; TIPS, transjugular intrahepatic portosystemic shunt; GAVE, gastric antral vascular ectasia; NVUGIB, nonvariceal nonmalignant upper gastrointestinal bleeding; UGIB, Upper gastrointestinal bleeding; LGIB, lower gastrointestinal bleeding; PHG, portal hypertensive gastropathy.