Outcomes of gastrointestinal defect closure with an over-the-scope clip system in a multicenter experience: An analysis of a successful suction method

Table 7 Details of over-the-scope clips clinical failure cases (n = 8)

Indication	Max. defect size, mm	Cause, comorbidity	Location	Prior therapy	Duration since onset	Technical success	Technical or clinical failure factor	Additional therapy	Clinical outcome
Refractory bleeding	8	Ileal ulcer bleeding due to steroid treatment for myelodysplastic syndrome	Terminal ileum	EI (hemoclips and coagulation)	Chronic	Yes	Suspicion of angiogenesis due to steroid in particular circumstances	Elective surgery	Survival
Refractory bleeding	20	Peptic ulcer, Refractory neurogenic disease	Stomach (body)	EI (coagulation)	Chronic	No	Fibrotic tissue	Retry of EI	Survival
Refractory bleeding	50	Peptic ulcer, Advanced gallbladder carcinoma	Stomach (body)	EI (coagulation)	Chronic	No	Fibrotic tissue	Retry of EI	Survival
Leak	7	Anastomotic leakage after surgery for gastric cancer	Esophageal gastric junction	None	Acute	Yes	Leakage by mucosal suture (suspected)	Elective surgery	Survival
Leak	21	Perforation during ERCP	Duodenal 2nd portion	None	Immediate	No	Inability of platform	Emergency surgery	Survival
Leak	50	Delayed perforation after ESD	Stomach (prepyrolus)	None	Acute	No	Location with narrow lumen	Elective surgery	Survival
Fistula	8	Interventional EUS	Gastric (prepyrolus)- pseudopancreatic cyst	None	Chronic	Yes	Leakage by mucosal suture (suspected)	Elective surgery	Survival
Fistula	22	Radiation for esophageal carcinoma	Gastric tube-trachea	Bronchial embolization	Chronic	No	Fibrotic tissue	Elective surgery	Survival

SS: Simple suction; TG: Twin Grasper; EI: Endoscopic intervention; ERCP: Endoscopic retrograde cholangiopancreatography; EUS: Endoscopic ultrasound.