P0605 - Hemostasis Outcomes With Hemospray in Managing Lower Gastrointestinal Bleeding: A Meta-Analysis

Sunday, October 22, 2023

3:30 PM – 7:00 PM PT

Location: Exhibit Hall

Presenting Author(s)

Rachel Porth, MD (she/her/hers)

Beth Israel Deaconess Medical Center
Boston, MA

Rachel Porth, MD¹, Vikas Taneja, MD², Isha Taneja, ³, Kelsey Anderson, MD¹, Shaharyar Zuberi, MD¹, Duncan J. Flynn, MD¹, Joseph D. Feuerstein, MD¹
¹Beth Israel Deaconess Medical Center, Boston, MA; ²Norwalk Hospital, Norwalk, CT; ³Massachusetts General Hospital for Children, Boston, MA

Introduction: Lower gastrointestinal bleeding (LGIB) is both a common cause of hospitalization and potentially life-threatening condition, but can also be challenging to treat. While there are therapeutic options including epinephrine injection, thermal, and mechanical therapies, Hemospray (TC-325), a sprayable powder, has emerged as a treatment for endoscopic hemostasis. However, studies regarding efficacy of Hemospray specifically in LGIB are limited. We therefore conducted a meta-analysis evaluating the immediate, short, and long term efficacy of hemostasis with Hemospray in adults with LGIB.

Methods: A systematic search was performed in PubMed for “hemospray” and “gastrointestinal hemorrhage”. Analyses were performed in R. Studies with LGIB in adult patients using Hemospray were included. Studies with 10 or fewer patients, case reports, letters to the editor, or review articles were excluded. The primary outcomes were immediate hemostasis, early rebleeding (within 7 days) and delayed rebleeding (30 day) after Hemospray application.

Results: Five studies were included for analysis with 132 total patients with lower GI bleeding. Primary cause of bleeding was post-procedural. Immediate hemostasis with Hemospray was achieved in 97.54% (95% confidence interval [CI] 94.63%-100%) of all patients. Early rebleeding (within 7 days) was seen in only 8.64% (95% CI 0-20.55%) of patients and delayed rebleeding (30 days) was seen in 13.20% (0-28.75%) of patients.

Discussion: Hemospray appears to be effective in the treatment for LGIB achieving both early hemostasis and sustained hemostasis at 30 days. While data is limited, Hemospray should be considered a first line treatment option for LGIB. Further studies are needed for subgroup analyses on the efficacy of Hemospray based on etiology of LGIB.

Figure: Immediate hemostasis and rebleeding outcomes with hemospray in lower gastrointestinal bleeding

				Location of Bleed
Author	Year	Number of Patients	Number of Bleeding Sites	Malignancy	Diverticular	Post procedural	Other
Chahal	2020	13	13	1	1	5	Ulcer= 1, IBD= 1, Anastomotic= 3, GVHD= 1
Chen	2015	17	17	2	0	9	Anastomotic ulcer=2, Radiation proctitis=1, Dieulafoy lesion= 1, AVM= 1, IC valve ulceration=1
De Santiago	2019	42	42	2	0	18	Surgical anastomosis= 9, ischemic ulcer= 5, angiodysplasia= 2, other= 6
Hookey	2019	50	52	0	1	40	Radiation proctopathy= 4, Colonic angiodysplasia= 3, visible vessel=1, peri-rectal tissue oozing=1, ischemic ulcer= 1= rectal polyp=1
Ng	2019	10	10	0	10	0
Total		132	134	5	12	72	45

Table: Location of lower gastrointestinal bleeding

Disclosures:

Rachel Porth indicated no relevant financial relationships.

Vikas Taneja indicated no relevant financial relationships.

Isha Taneja indicated no relevant financial relationships.

Kelsey Anderson indicated no relevant financial relationships.

Shaharyar Zuberi indicated no relevant financial relationships.

Duncan Flynn indicated no relevant financial relationships.

Joseph Feuerstein indicated no relevant financial relationships.

Rachel Porth, MD¹, Vikas Taneja, MD², Isha Taneja, ³, Kelsey Anderson, MD¹, Shaharyar Zuberi, MD¹, Duncan J. Flynn, MD¹, Joseph D. Feuerstein, MD¹. P0605 - Hemostasis Outcomes With Hemospray in Managing Lower Gastrointestinal Bleeding: A Meta-Analysis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.