PTU-24 The role of Hemospray as a monotherapy treatment of Gastrointestinal bleeds

IntroductionDual endoscopic therapy has been considered the standard of care for endoscopic management of GI bleeding. We aimed to look at the outcomes of Hemospray as a monotherapy treatment for GI bleeds.MethodsData was collected on patients with GI bleeds treated with Hemospray monotherapy in 18 centres. Haemostasis was defined as cessation of bleeding within 5 minutes of hemospray application.Results62 patients with peptic ulcer bleeds were treated. There was an immediate haemostasis of 90% (56/62), re-bleed rate of 16% (7/44) (Table 1). 69% were Forrest 1a/1b ulcers.72 patients with malignancy related bleeds. There was a haemostasis rate of 100% and a re-bleed rate of 18% (11/63). There was a haemostasis rate of 100% with post endoscopic therapy bleeds. 48% were post endoscopic mucosal resection.22 patients with lower GI bleeds were treated. 36% secondary to colonic tumours. There was a haemostasis rate of 96% (21/22) and re-bleed of 26% (5/19). A 100% haemostasis was achieved in 5 patients treated for gastric angiodysplasia with one re-bleed.Abstract PTU-24 Table 1Outcomes of treatment with Hemospray monotherapy Peptic ulcer(N =62) Malignancy (n = 72) Post endoscopic therapy(N=23) Lower GI bleeds (N = 22) Angiodysplasia(N =5) Inflammation(N =22) Variceal (N =7) Haemostasis 56/62 (90%) 72/72 (100%) 23/23 (100%) 21/22 (96%) 5/5(100%) 21/22(96%) 4/7 (57%) Rockall 7(IQR, 7-8) 8(IQR, 7-9) 6(IQR, 5-6) n/a 7(IQR, 6-7) 7(IQR, 6-8) 8(IQR, 7-8) Re-bleed 7/44 (16%) 11/63(18%) 1/20 (5%) 5/19 (26%) 1/5(20%) 4/19(21%) 1/3 (33%) 7-day mortality 6/50 (12%) 5/63(8%) 1/20 (5%) 2/20 (10%) 0 5/20(25%) 3/6 (50%) 30-day mortality 15/50 (30%) 17/63 (27%) 1/20 (5%) 4/20 (20%) 0 10/20(50%) 3/6 (50%) ConclusionsResults show high haemostasis and comparable re-bleed rates with Hemospray monotherapy treatment. It may play a potential role in actively bleeding peptic ulcers in difficult anatomical positions to help bridge towards definitive therapy. These data may represent the evolution of new treatment paradigms as experience with haemostatic powders increases.