Image: The aerosol device is designed to help control GI bleeding (Photo courtesy of Cook Medical).
A novel device helps control hemorrhage within the upper and lower gastrointestinal (GI) tract, such as those caused by gastric ulcers, cancer, malformed blood vessels, diverticulosis, or inflammatory bowel disease (IBD).
The Cook Medical (Bloomington, IN, USA) Hemospray is a single-use device that delivers hemostatic powder through the channel of an endoscope toward the source of a bleed. The proprietary inorganic powder absorbs water when it comes in contact with blood, forming a gel barrier that acts cohesively and adhesively to create a stable mechanical barrier that covers the bleeding site. The mineral spray can be delivered to a wide area through an endoscope, covering large ulcers, tumors, or diffuse and hard-to-visualize bleeds.
Hemospray is contraindicated in patients at high risk for GI perforations or with a fistula. The spray is also not intended for use in patients with variceal bleeding, such as from the enlarged veins related to alcoholic liver disease. In a review that summarized 19 studies of the Hemospray device, comprising treatment of 234 patients, a combined rate of successful hemostasis of 88.5% within five minutes was demonstrated. Recurrent bleeding occurred within 72 hours in 16.2% of the patients after successful initial hemostasis with Hemospray.
“Current endoscopic hemostasis treatment options can be challenging. Thermal, mechanical, or contact devices can carry a risk of further tissue damage, and require precise placement of the device directly onto the bleeding vessel,” claimed Cook Medical in a press release. “The Hemospray device represents a different approach to treat GI bleeds by helping to achieve hemostasis without the precision or direct visualization required of other current treatments.”
GI bleeding incorporates all forms of bleeding in the GI tract, from the mouth to the rectum; about 2/3 of all GI bleeds are from upper sources and 1/3 from lower sources. Small amounts of bleeding over a long time may cause iron-deficiency anemia resulting in fatigue, chest or abdominal pain, shortness of breath, and pale skin. Massive bleeding can result in vomited blood, shock, and syncope. Blood that is digested may appear black rather than red, resulting in brown vomit or tar colored stool called melena.