A Hemostatic Powder for Upper Gastrointestinal Bleeding Shows Promise

In a small case series, a nonbiologic powder, TC-325, achieved hemostasis in all patients without any adverse events.

Endoscopic therapy using coagulation, clips, and sclerosis has been demonstrated to improve outcomes for patients with nonvariceal upper gastrointestinal bleeding (UGIB). However, these methods are time-consuming and difficult to use for controlling widespread bleeding, as with a malignancy or after mucosal resection. A new, nonbiologic powder, TC-325, has been shown to be cohesive and adhesive, forming a mechanical barrier to bleeding. Ex vivo study results suggest that it may also activate the clotting cascade. Now, researchers in France have documented their experience using this compound in 12 patients with postprocedure- or malignancy-related UGIB.

The TC-325 powder was sprayed directly on the bleeding area using a catheter. Immediate hemostasis was achieved in all patients. It was the first-line therapy in 8 of 12 patients after procedure-related bleeding and in 4 of 5 patients with malignancy. In the other patients it was used after the failure of conventional therapy. Rebleeding was suspected in 2 of the patients with procedure-related bleeding, but repeat endoscopy failed to identify any active bleeding. Rebleeding was documented by endoscopy in 2 patients with tumors, both of whom responded to repeat therapy. One patient bled a third time and was considered a treatment failure. The authors report no adverse events. They conclude that TC-325 seems to be effective in this setting but that further studies are needed.

CITATION(S):

Leblanc S et al. Early experience with a novel hemostatic powder used to treat upper GI bleeding related to malignancies or after therapeutic interventions (with videos). Gastrointest Endosc 2013 Apr 26; [e-pub ahead of print].