Endoscopic advances in the management of non-variceal upper gastrointestinal bleeding: A review

Table 4 Efficacy and safety of over the scope clips in the management of non-variceal upper gastrointestinal bleeding (2009-2018)

Authors and year of publication	Study design	Study participants	Sample size	Duration	Outcomes of the study	Success rate
Repici et al[33], 2009	Retrospective	Mean age, 70 yr, gender (M/F): 5/2	7	Unknown	Success rates with the first endoscopic therapy	Success rates with the first endoscopic therapy
Kirschniak et al[34], 2011	Retrospective	Mean age, 68 yr, gender (M/F): 18/9	27	2006-2010	1 Success rates with the first endoscopic therapy	Primary hemostasis was achieved in all cases (100%) Rebleeding was observed in 2 cases
					2 Rebleeding episodes
Albert et al[35], 2011	Retrospective	Mean age, 62 yr, gender (M/F): 5/2	7	Unknown	1 Success rates with the first endoscopic therapy	Primary success rate was observed in 100%
					2 Rebleeding episodes
Skinner et al[36], 2014	Retrospective	Mean age, 59 yr, gender (M/F): 8/5	12	2012-2013	1 Success rates with the first endoscopic therapy	Hemostasis was achieved in all patients. Rebleeding occurred in two patients 1 d and 7 d after OTSC placement
					2 Rebleeding episodes
Nishiyama et al[37], 2013	Retrospective	Mean age, 77 yr, gender (M/F): 5/4	9	2011-2012	Success rates with the first endoscopic therapy	Primary success rate was observed in 77.8%
Manta et al[39], 2013	Retrospective	Mean age, 64 yr, gender (M/F): 14/16	30	2011-2012	1 Success rates with the first endoscopic therapy	Primary hemostasis was achieved in 29 of 30 cases (97%) Rebleeding was observed in two cases (one duodenal bulb and one gastric ulcer)
					2 Rebleeding episodes
Manno et al[38], 2016	Retrospective	Mean age, 69 yr, gender (M/F): 33/7	40	2013-2014	1 Success rates with the first endoscopic therapy	Technical success and primary haemostasis were achieved in all patients (100%). No re-bleeding need for surgical or radiological embolization treatment or other complications were observed during the follow-up period of 30 d
					2 Rebleeding episodes
Richter-Schrag et al[40], 2016	Retrospective	Mean age, 72 yr, gender (M/F): 58/35	93	2012-2016	1 Success rates with the first endoscopic therapy	Primary hemostasis and clinical success of bleeding lesions (without rebleeding) was achieved in 88/100 (88%) and 78/100 (78%), respectively
					2 Rebleeding episodes
Wedi et al[41], 2016	Retrospective	Mean age, 71 yr, gender (M/F): 50/34	84	2009-2012	Success rates with the first endoscopic therapy	Success rate 35/41 (85.36%)
Lamberts et al[42], 2017	Retrospective	Mean age, 71.7 yr, gender (M/F): 55/20	75	February 2011 and June 2014	1 Success rates with the first endoscopic therapy	Application of the OTSC resulted in immediate hemostasis (primary success rate) in all 75 patients. However, in 34.7 % a rebleeding episode was noted that could be treated by further endoscopic interventions. Only 3 patients had to be sent to the operating room because of failure of endoscopic therapy. In the rebleeding group the use of antiplatelet therapies was higher (73.1% vs 48.9%)
					2 Rebleeding episodes
Brandler et al[43], 2018	Retrospective	Mean age, 71 yr, gender (M/F): 38/29	67	2011-2015	OTSC safety and efficacy in GI bleeding	OTSC success rate of 81.3%
Schmidt et al[44], 2018	Prospective, randomized, controlled multicenter trial	Mean age: 77 yr, gender (M/F): 37/29	67	March 2013 to September 2016	1 Persistent bleeding despite endoscopic therapy according to the protocol or	Persistent bleeding after per-protocol hemostasis was observed in 14 patients (42.4%) in the standard therapy group and 2 patients (6.0%) in the OTSC group (P < 0.001) Recurrent bleeding within 7 d occurred in 5 patients (16.1%) in the standard therapy group vs 3 patients (9.1%) in the OTSC group (P = 0.468)
					2 Recurrent bleeding within 7 d after initial successful endoscopic therapy

GI: Gastrointestinal; OTSC: Over-The-Scope Clip.