Topical hemostatic agents: A systematic review with particular emphasis on endoscopic application in GI bleeding

摘要

GI bleeding (GIB) remains a major cause of morbidity and mortality worldwide. Endoscopic management of GIB could be challenging, despite the existing advancements in hemostatic techniques; there are unmet needs for the introduction of topical hemostatic agents in management of profound venous or arterial GIB and malignant lesions with a large surface area that are not quite amenable to traditional endoscopic hemostatic techniques. Many topical hemostatic agents have been developed over the past 50 years with widespread medical applications.1 The introduction of topical hemostatic agents in the modern surgical era can be traced back to 1909, when Bergel first discussed the use of topical fibrin for hemostasis. This class of preparations, known as fibrin sealants, marked the beginning of wide spectrum of topical hemostatic agents with various mechanisms of action.