Hemostasis & Clip Retention
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
TRUE or FALSE:
When removing a Resolution 360 clip from the packaging and preparing for insertion into the endoscope, the catheter should NOT be fully unwound and held in a U shape
What is:
FALSE
The catherer SHOULD be completely unwound and held in a you position prior to inserting into the endoscope
Name the three types of Boston Scientific Clips currently available
What are:
Resolution Clip (Legacy Clip)
Resolution360 Clip
*NEW* Resolution360 ULTRA Clip (17mm)
What is:
Combination Therapy
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
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)
Name two indications for clips
What are:
Hemostasis, endoscopic marking, j-tube anchoring, closure of GI tract perforations <20mm, post lesion resection prophylactic clipping
TRUE or FALSE:
Prophylactic Clipping can reduce the risk of delayed bleeds
What is:
TRUE
In the Pohl Clinical Study, delayed hemorrhage rate in lesions =>2cm reduced 80% in fully clipped patients compared to non-clipped patients
Delayed hemorrgage rates were 9.7% in non-clipped groups and 1.8% in fully clipped groups
How long can the process of angiogenesis take in the GI Tract?
What is:
30 Days
The phrase "Snap, Crackle, & ___" is often used when desrcibing the deployment process of a Resolution Clip
What is:
Pop!
The Resolution clips have ______, which help improve retention
What is:
Locking Windows
What is:
The use of two or more forms of hemostatic treatment
example: epinepherine injection & endoscopic clips at the site of bleeding
The Resolution clip is the most studied endoscopic clip and has proven superior retention. How many clinical articles have been published related to the Resolution Clip?
What is:
Over 400!
How many times can a Resolution Clip be opened and closed prior to deployment?
(A) Never (B) Twice (C) Five Times (D) 100 Times
What is:
(C) Five Times
The Resolution clips are indicated for opening (not deployment) and closing up to five times prior to deployment to ensure proper positioning
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
In the Rex Clinical Study, what % of patients were hospitalized with delayed hemorrgage?
What is:
85%