Systematic Reviews
Copyright ©The Author(s) 2020.
World J Gastroenterol. Jun 28, 2020; 26(24): 3495-3516
Published online Jun 28, 2020. doi: 10.3748/wjg.v26.i24.3495
Table 1 Over-the-scope clip types available for endoscope diameter and applicator clip depth2
OTSC cap options
Mini (10)111214
Scope outer diameter compatibility8.5-9.8 mm8.5-11 mm10.5-12 mm11.5-14 mm
Diagnostic gastroscopesDiagnostic gastroscopes1T/2T gastroscopes, peds colonoscopesAdult colonoscopes
Maximum outer diameter of cap14.65 mm16.5 mm17.5 mm21 mm
Thread length165 cm165 cm165 cm or 220 cm220 cm
Depth of applicator cap
3 mma, ta, ta, ta, t
6 mmN/Aa, ta, t, gc1a, t
Table 2 Summary of included studies (overall clinical success rate, per-indication clinical success rate, and overall over-the-scope clip-related adverse event rate)
Ref.
Year
Type of study
Country
Patients (n)
Overall clinical success rate (%)
Follow-up (wk)
Adverse events,n (%)
Indications
Total
FistulaBleedingPerforationLeakERStent fixation
Seebach et al[15]2010Case series RetrospectiveSwitzerland7--57.1---57.110-42NR
Kirschniak et al[2]2007RetrospectiveGermany11-100100-100-1001-50.0
Mudumubi et al[16]2014RetrospectiveInternational112-----83.383.33-400.0
Sandmann et al[17]2011Case series RetrospectiveGermany11100-10066100-90.912.7NR
Albert et al[18]2011RetrospectiveGermany19-57.1-66.7--63.21-680.0
Repici et al[19]2009Case series RetrospectiveItaly9-100--100-1004-120.0
Donatelli et al[20]2016RetrospectiveInternational24536.7-100---57.836-1000.0
Maekawa et al[21]2015ProspectiveJapan12----91.7-91.7NR0.0
Gautier et al[22]2015Retrospective Multi-centerFrance1711.8-----11.812NR
Nishiyama et al[23]2013RetrospectiveJapan237577.875-100-82.62-80.0
Voermans et al[24]2012Prospective Multi-centerNetherlands36--88.9---88.91-260.0
Lee et al[26]2017Prospective Multi-centerKorea1925-10083.3100-73.7720.0
Angsuwatcharakon et al[27]2016RetrospectiveThailand6--83.3---83.3NRNR
Arezzo et al[28]2012Case series ProspectiveItaly14---85.7--85.7160.0
Schlag et al[29]2013ProspectiveGermany6--100---1004-120.0
Disibeyaz et al[30]2012Case series RetrospectiveTurkey933.3-10060--55.6NR0.0
Gubler et al[31]2012Case series ProspectiveSwitzerland14--85.7---85.74-48NR
Singhal et al[32]2014Case Series ProspectiveUnited States1090-----9070.0
Mennigen et al[33]2013Case series RetrospectiveGermany1471.4-10083.3--78.61-680.0
Faehndrich et al[34]2015RetrospectiveGermany17----94.1-94.1NR0.0
Schmidt et al[4]2015Prospective Multi-center RCTInternational324----75-7542 (8.3)
Guo et al[35]2015RetrospectiveChina23----100-1004-242 (8.7)
Correia et al[36]2014Case series ProspectivePortugal680-100---83.3NR0.0
Goenka et al[37]2017ProspectiveIndia1266100100---91.74-80.0
Surace et al[38]2011ProspectiveItaly1973.7-----73.7321 (5.3)
Kochhar et al[39]2017Case series ProspectiveUnited States12---66.7--66.7601 (8.3)
Manta et al[40]2017ProspectiveItaly76---80.3--80.3NR0.0
Parodi et al[41]2010ProspectiveItaly1080-10050--80.0NR0.0
Manta et al[42]2011Case series RetrospectiveItaly1287.5--75--83.340.0
Honegger et al[43]2017Retrospective CohortSwitzerland20329.877.486.133.3-66.763.146 (3.0)
Manno et al[44]2015RetrospectiveInternational440-100----10040.0
Richter-Schrag et al[45]2016RetrospectiveGermany100-78----78NRNR
Aepli et al[46]2016RetrospectiveSwitzerland24----87.5-87.5NR4 (16.7)
Law et al[48]2015Retrospective Multi-centerUnited States4753.2-----53.2260.0
Farnik et al[3]2015Retrospective Multi-centerInternational534--10056.3--70.5390.0
Jacobsen et al[49]2012RetrospectiveUnited States100-10080--70.0120.0
Haito-Chavez et al[50]2014Retrospective Multi-centerInternational616142.9-9073.3--60.218 – 300.0
Winder et al[51]2016RetrospectiveUnited States2877.2--100--82.1190.0
Sulz et al[52]2014Case series ProspectiveSwitzerland1954.5100-66.7-10063.1NR0.0
Magdeburg et al[53]2015ProspectiveGermany43--97.8---97.8NR3 (7.0)
Wedi et al[54]2016RetrospectiveFrance8410089.357.1-100-89.3NR2 (2.4)
Keren et al[55]2014Case series ProspectiveIsrael26---80.8--80.8NR0.0
Raithel et al[14]2017Retrospective Multi-centerGermany34--74.185.7--76.5NR3 (8.8)
Kobara et al[56]2017Retrospective Multi-centerJapan5883.383.3-85.7--84.54+1 (1.8)
Hagel et al[57]2012Case series ProspectiveGermany17--64.7---64.74NR
Nasa et al[58]2016Case series RetrospectiveIndia780100100---85.745NR
Skinner et al[6]2014RetrospectiveUnited States12-83.3----83.310 – 300.0
Al-Bawardy et al[59]2017RetrospectiveUnited States7----100-1001 – 860.0
Sarker et al[60]2014RetrospectiveUnited States8----100-1004 – 520.0
Mangiavillano et al[61]2016RetrospectiveItaly20--90---9012NR
Aiolfi et al[62]2014RetrospectiveItaly7---85.7--85.7NRNR
Manta et al[5]2013Case series Multi-centerItaly30-90----901 – 40.0
Mangiafico et al[63]2017Case series ProspectiveInternational77100-----1002 – 80.0
Niland et al[64]2017RetrospectiveUnited States1421.4-----21.4260.0
Schmdtt et al[4]2018Prospective RCTInternational833-84.8----84.840.0
Heinrich et al[65]2017Case series RetrospectiveSwitzerland5100-----10046 – 2690.0
Prosst et al[66]2015ProspectiveGermany2090-----90240.0
Mizrahi et al[67]2016ProspectiveUnited States5135.3757550-5049.048NR
Kirschniak et al[68]2011RetrospectiveGermany4637.593100---84.81 – 20.0
Mennigen et al[69]2015RetrospectiveGermany1070-----7022 – 750.0
Wedi et al[70]2016Retrospective Case seriesInternational96-100----100NRNR
Baron et al[71]2012Retrospective Multi-centerUnited States4367.91008033.3--72.14 – 112 (4.7)
Lamberts et al[72]2017RetrospectiveGermany75-65.3----65.3NRNR
Soetikno et al[73]2016Case series RetrospectiveInternational105-100----100600.0
Wedi et al[74]2017RetrospectiveInternational11100-86----73NRNR
Chan et al[75]2014Case series ProspectiveChina9-77.8----77.88NR
Keen et al[76]2019ProspectiveUnited Kingdom59-93.2----93.24NR
Horenkamp-Sonntag et al[77]2019RetrospectiveGermany92-82.487.9---92.414NR
Manta et al[78]2019Retrospective Multi-centerItaly286-94.4----94.44NR
Mercky et al[79]2015RetrospectiveFrance3073.3-----73.3423 (10)
Monkemuller et al[80]2014Case series RetrospectiveGermany1650100-010010075440.0
Bonino et al[81]2014Case series ProspectiveItaly2690-68.8---76.9NR0.0
Christophorou et al[82]2015Retrospective Multi-centerFrance1478.5-----78.5NRNR
Lunse et al[83]2019RetrospectiveGermany966.7-----66.780.0
Mosquera-Klinger et al[84]2019Retrospective Case seriesColumbia1470100100--10078.6200.0
Brander et al[25]2017RetrospectiveUnited States67-70.1----70.14NR
Meier et al[47]2017RetrospectiveGermany10----100-100120.0
Tashima et al[85]2017ProspectiveJapan50----94-9424 (8)
Khater et al[86]2017RetrospectiveFrance11--81.2---81.2NR1 (9)
Asokkumar et al[87]2018RetrospectiveInternational1219-100----100NR0.0
Morrell et al[88]2019RetrospectiveUnited States11750.8--75--61.2220.0
Kappelle et al[89]2018ProspectiveNetherlands13----84.6-84.6245 (38.4)
Wei et al[90]2019RetrospectiveChina26--100---10040.0
Golder et al[91]2019RetrospectiveGermany100-75----75NR0.0
Wedi et al[92]2018Retrospective Multi-centerGermany118-92.4----92.44NR
Total302555.8%86.0%85.3%72.6%92.8%80.0%78.4%-2.1%
347/6221120/1303399/468284/391205/22116/202371/3025-40/194213
Table 3 Over-the-scope clip-related adverse events, per-indication
Incorrect placement sitePerforationBleedingInfectionOverall
Fistula03025
Bleeding00000
Perforation222217
Leak11013
ER427619
Stent fixation00000
Total78910341
Table 4 Per-indication clinical success rate, technical success rate, and post-over-the-scope clip surgery rates
Clinical success rate (%), (n/N)Technical success rate (%), (n/N)Post-over the scope clip surgical rate (%), (n/N)
Fistula55.8 (347/622)92.8 (577/622)7.6 (47/622)
Bleeding86.0 (1120/1303)96.8 (1261/1303)1.6 (21/1303)
Perforation85.3 (399/468)95.5 (447/468)9.4 (44/468)
Leak72.6 (284/391)86.7 (339/391)7.4 (29/391)
ER92.8 (205/221)95.9 (212/221)0.9 (2/221)
Stent fixation80.0 (16/20)100 (20/20)0.0 (0/20)
Overall78.4 (2371/3025)94.4 (2856/3025)4.7 (143/3025)
Table 5 Summary of prospective studies (overall clinical success rate, per-indication clinical success rate and adverse event rate)
Ref.
Year
Type of study
Country
Patients (n)
Overall clinical success rate (%)
Follow-up (wk)
Adverse events, n (%)
Indications
Total
FistulaBleedingPerforationLeakER3Stent fixation
Maekawa et al[21]2015ProspectiveJapan12----11/12-11/12NR0.0
Voermans et al[24]2012Prospective Multi-centerNetherlands36--32/36---32/261-260.0
Lee et al[26]2017Prospective Multi-centerKorea191/4-1/110/121/2-13/19720.0
Arezzo et al[28]2012Case series ProspectiveItaly14---12/14--12/14160.0
Schlag et al[29]2013ProspectiveGermany6--6/6---6/64-120.0
Gubler et al [31]2012Case series ProspectiveSwitzerland14--12/14---12/144-48NR
Singhal et al[32]2014Case series ProspectiveUnited States109/10-----9/1070.0
Schmidt et al[4]2015Prospective Multi-center RCTInternational124----18/24-18/2442 (8.3)
Correia et al[36]2014Case series ProspectivePortugal64/5-1/1---5/6NR0.0
Goenka et al[37]2017ProspectiveIndia122/36/63/3---11/124-80.0
Surace et al[38]2011ProspectiveItaly1914/19-----14/19321 (5.3)
Kochhar et al[39]2017Case series ProspectiveUnited States12---8/12--8/12601 (8.3)
Manta et al[40]2017ProspectiveItaly76---61/76--61/76NR0.0
Parodi et al[41]2010ProspectiveItaly104/5-3/31/2--8/10NR0.0
Sulz et al[52]2014Case series ProspectiveSwitzerland196/111/1-4/6-1/112/19NR0.0
Magdeburg et al[53]2015ProspectiveGermany43--42/43---42/43NR3 (7.0)
Keren et al[55]2014Case series ProspectiveIsrael26---21/26--21/26NR0.0
Hagel et al[57]2012Case series ProspectiveGermany17--11/17---11/174NR
Mangiafico et al[63]2017Case series ProspectiveInternational277/7-----7/72-80.0
Schmdtt et al[4]2018Prospective RCTInternational333-28/33----28/3340.0
Prosst et al[66]2015ProspectiveGermany2018/20-----18/20240.0
Mizrahi et al[67]2016ProspectiveUnited States516/173/43/412/24-1/225/5148NR
Chan et al [75]2014Case series ProspectiveChina9-7/9----7/98NR
Keen et al[76]2019ProspectiveUnited Kingdom59-55/59----55/594NR
Tashima et al[85]2017ProspectiveJapan50----47/50-47/5024 (8)
Kappelle et al[89]2018ProspectiveNetherlands13----11/13-11/13245 (38.4)
Total61770.3%89.3%89.1%75.0%87.1%66.7%81.7%-3.4%
71/101100/112114/128129/17288/1012/3504/617-16/4674