Incomplete hemostasis of high-risk adverse outcome bleeding?lesions after placement of the over-the-scope clip: causes and solutions

摘要

High-risk adverse outcome (HR-AO) bleeding lesions—large-caliber (2 mm) vessel or high-risk stigmata within deep penetrating and fibrotic ulcers located in the distribution of major arteries where endoscopic therapy can cause adverse events—are at significant risk of treatment failure. Although over-the-scope clips (OTSCs) are effective in such lesions, they can sometimes fail to achieve hemostasis. We describe the causes of incomplete hemostasis and provide solutions to mitigate such OTSC failures.