ABSTRACT
INTRODUCTION: The over-the-scope-clip (OTSC) can potentially overcome limitations of standard clips and achieve more efficient and reliable hemostasis. Data on OTSC use for non-variceal upper gastrointestinal bleeding (NVUGIB) in patients with cardiovascular comorbidities are currently limited. PATIENTS AND METHODS: We prospectively collected and retrospectively analyzed our database from February 2009 to September 2015 from all patients who underwent emergency endoscopy for high-risk NVUGIB in 2 academic centers and were treated with OTSC as first-line (nâ=â81) or second-line therapy (nâ=â19). RESULTS: One hundred patients mean age 72 (range 27â-â97 years) were included in this study. Fifty-one percent (n =â51) had severe cardiovascular co-morbidity (ischemic heart disease, congestive heart failure, hypertension, valvular heart disease, peripheral arterial occlusive disease and atrial fibrillation) and 73â% (nâ=â73) were on antiplatelet or/and anticoagulation therapy. The median size of the treated ulcers was 3âcm (range 1â-â5âcm). In 94â% (n =â94) primary hemostasis with OTSC was achieved. Clinical long-term success during a mean 6-month follow-up without rebleeding was 86â% (nâ=â86). CONCLUSIONS: In this cohort OTSC was demonstrated to be a safe and effective first- or second-line treatment for NVUGIB in high-risk patients with cardiovascular disease and complex, large ulcers.