Hemostatic Clipping

GI Bleeding

100

Name 2 Risk Factors related to GI Bleeding

What are:

Active Bleeding, Age >50 years, Significant Coagulopathy, Multiple Comorbidities, Large volume red blood cell transufion, Hypotension or shock, Gender, Inpatient Status at time of Bleed

200

What are the 3 Stages of Hemostasis?

What is:

Step 1: Vasoconstriction: brief reflexive contraction of the blood vessel which increases blood pressure, but decreases blood flow

Step 2: Platelet Aggregation: activation, aggregation, and adherence of platelets into a plug that serves as a barrier against blood flow

Step 3: Clot Formation: Coagulation occurs and fibrin mesh presents acting as a molecular glue, holding the platelet plug together

300

How long can the process of angiogenesis take in the GI Tract?

What is:

30 Days

ASGE Recommendations

100

It's always important to review current medications prior to treating any patient, however, the ASGE recommends "special attention" to what type of medications?

What are:

Anticoagulants, anteplatelet agents, or meds associated with GI hemorrhage (NSAIDS)

200

The ASGE recommends _______ therapy for the treatment for patients with either diverticular bleeding or peptic ulcers

What is:

Combination Therapy

300

Define Combination Therapy

What is:

The use  of two or more forms of hemostatic treatment

example: epinepherine injection & endoscopic clips at the site of bleeding

Clips, Clips, Clips

100

Name three indications for clips

What are:

Hemostasis, endoscopic marking, j-tube anchoring, closure of GI tract perforations <20mm), post lesion resection prophylactic clipping 

200

What are the two ways the Resolution 360 and Resolution 360 ULTRA clips can be rotated?

What are:

1) Physician controlled rotation (32 wire braided catheter)

2) Assistant controlled rotation (via orange spindle)

300

The Resolution 360 ULTRA Clip has ___% more tissue capture than the Resolution Clip & has a ___mm jaw opening

What are:

64% more tissue capture & 17mm jaw opening

Clinical Literature

100

TRUE or FALSE:

The location of colonic polyp removal is a key factor in deciding whether or not to clip

What is:

TRUE

The closer to the cecum, the higher the risk of bleeding

200

Delayed hemorrhage rate in lesions =>2cm reduced __% in fully clipped patients:

A) 15%  B) 65%  C) 80%

What is:

80%

Delayed hemorrgage rates were 9.7% in non-clipped groups and 1.8% in fully clipped groups

300

What % of patients are hospitalized with delayed hemorrgage?

What is:

85%