Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Aug 16, 2019; 11(8): 443-453
Published online Aug 16, 2019. doi: 10.4253/wjge.v11.i8.443
Potential role of new technological innovations in nonvariceal hemorrhage
David Friedel
David Friedel, Department of Gastroenterology, New York University Winthrop Hospital, Mineola, NY 11501, United States
Author contributions: Friedel D contributed to the manuscript.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: David Friedel, AGAF, MD, Associate Professor, Department of Gastroenterology, New York University Winthrop Hospital, 222 Station Plaza North, Suite 428, Mineola, NY 11501, United States. dfriedel@winthrop.org
Telephone: +1-516-6634623
Received: May 12, 2019
Peer-review started: May 14, 2019
First decision: June 3, 2019
Revised: June 16, 2019
Accepted: July 20, 2019
Article in press: July 3, 2019
Published online: August 16, 2019

The present armamentarium of endoscopic hemostatic therapy for non-variceal upper gastrointestinal hemorrhage includes injection, electrocautery and clips. There are newer endoscopic options such as hemostatic sprays, endoscopic suturing and modifications of current options including coagulation forceps and over-the-scope clips. Peptic hemorrhage is the most prevalent type of nonvariceal upper gastrointestinal hemorrhage and traditional endoscopic interventions have demonstrated significant hemostasis success. However, the hemostatic success rate is less for other entities such as Dieulafoy’s lesions and bleeding from malignant lesions. Novel innovations such as endoscopic submucosal dissection and peroral endoscopic myotomy has spawned a need for dependable hemostasis. Gastric antral vascular ectasias are associated with chronic gastrointestinal bleeding and usually treated by standard argon plasma coagulation (APC), but newer modalities such as radiofrequency ablation, banding, cryotherapy and hybrid APC have been utilized as well. We will opine on whether the newer hemostatic modalities have generated success when traditional modalities fail and should any of these modalities be routinely available in the endoscopic toolbox.

Keywords: NoN-variceal upper gastrointestinal hemorrhage, Endoscopic hemostasis, Gastric antral vascular ectasias, Over-the-scope clips, Endoscopic suturing

Core tip: New devices are available for hemostasis of non-variceal upper gastrointestinal hemorrhage that may supplement or supplant traditional modalities. These devices however have a varying track record in hemostasis with different learning curves, costs and detriments.