Table 2.

Summary of Techniques With Their Therapeutic Applications, Advantages, Disadvantages, and Level of Evidence

Technique	Therapeutic Application(s)	Advantages	Disadvantages	Level of Evidence
Doppler endoscopic probe	Doppler-guided therapeutic endpoints for high-risk lesions and ulcers Diverticular hemorrhage	Decreased rates of rebleeding Doppler-guided endpoints as immediate, intraprocedure feedback	Requires specialized training Limited availability outside of major academic medical centers	Randomized, single-blinded, clinical trial Prospective cohort studies
Over-the-scope clips	High-risk lesions Rescue therapy for refractory bleeding Large, cratered, and/or fibrotic ulcers	Significantly higher tensile force Significantly larger size	Requires some degree of training and experience Somewhat limited visualization and maneuverability	One multicenter randomized trial Most studies are retrospective analyses
Hemostatic powders	Tumor-related bleeding Bridge to definitive therapy Diffuse or refractory bleeding Adjunct/bridge therapy for variceal bleed	≥95% initial hemostasis rate Minimal training required; ease of use	High rebleeding rates (30%-40%) Short therapeutic duration (24-48 hours)	Largely retrospective analyses Single randomized, controlled trial for adjunct therapy in variceal bleeding
EUS-guided variceal embolization	Gastric fundal varices bleeding (GOV2s, IGV1s)	Preserved visualization via Doppler during massive hemorrhage High hemostasis rates during acute bleed Decreased amounts of glue used, especially when combined with coil embolization Decreased number of sessions required for variceal eradication	Requires specialized training in EUS Limited availability outside of major academic medical centers Glue emboli still occur Risk of damaging endoscopes	All studies are retrospective analyses
EUS, endoscopic ultrasound; GOV2s, gastroesophageal varices; IGV1s, isolated gastric varices.