International multicenter experience with an over-the-scope clipping device for endoscopic management of GI defects (with video)

Yamile Haito-Chavez, Joanna K. Law, Thomas Kratt, Alberto Arezzo, Mauro Verra, Mario Morino, Reem Z. Sharaiha, Jan Werner Poley, Michel Kahaleh, Christopher C. Thompson, Michele B. Ryan, Neel Choksi, B. Joseph Elmunzer, Sonia Gosain, Eric M. Goldberg, Rani J. Modayil, Stavros N. Stavropoulos, Drew B. Schembre, Christopher J. Di Maio, Vinay ChandrasekharaMuhammad K. Hasan, Shyam Varadarajulu, Robert Hawes, Victoria Gomez, Timothy A. Woodward, Sergio Rubel-Cohen, Fernando Fluxa, Frank P. Vleggaar, Venkata S. Akshintala, Gottumukkala S. Raju, Mouen A. Khashab

Research output: Contribution to journalArticle

119 Citations (Scopus)

Abstract

Background: The over-the-scope clip (OTSC) provides more durable and full-thickness closure as compared with standard clips. Only case reports and small case series have reported on outcomes of OTSC closure of GI defects. Objective: To describe a large, multicenter experience with OTSCs for the management of GI defects. Secondary goals were to determine success rate by type of defect and type of therapy and to determine predictors of treatment outcomes. Design: Multicenter, retrospective study. Setting: Multiple, international, academic centers. Patients: Consecutive patients who underwent attempted OTSC placement for GI defects, either as a primary or as a rescue therapy. Interventions: OTSC placement to attempt closure of GI defects. Main Outcome Measurements: Long-term success of the procedure. Results: A total of 188 patients (108 fistulae, 48 perforations, 32 leaks) were included. Long-term success was achieved in 60.2% of patients during a median follow-up of 146 days. Rate of successful closure of perforations (90%) and leaks (73.3%) was significantly higher than that of fistulae (42.9%) (P < .05). Long-term success was significantly higher when OTSCs were applied as primary therapy (primary 69.1% vs rescue 46.9%; P = .004). On multivariate analysis, patients who had OTSC placement for perforations and leaks had significantly higher long-term success compared with those who had fistulae (OR 51.4 and 8.36, respectively). Limitations: Retrospective design and multiple operators with variable expertise with the OTSC device. Conclusion: OTSC is safe and effective therapy for closure of GI defects. Clinical success is best achieved in patients undergoing closure of perforations or leaks when OTSC is used for primary or rescue therapy. Type of defect is the best predictor of successful long-term closure.

Original languageEnglish (US)
Pages (from-to)610-622
Number of pages13
JournalGastrointestinal Endoscopy
Volume80
Issue number4
DOIs
StatePublished - 2015

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Surgical Instruments
Equipment and Supplies
Fistula
Therapeutics
Multicenter Studies
Multivariate Analysis
Retrospective Studies

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

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International multicenter experience with an over-the-scope clipping device for endoscopic management of GI defects (with video). / Haito-Chavez, Yamile; Law, Joanna K.; Kratt, Thomas; Arezzo, Alberto; Verra, Mauro; Morino, Mario; Sharaiha, Reem Z.; Poley, Jan Werner; Kahaleh, Michel; Thompson, Christopher C.; Ryan, Michele B.; Choksi, Neel; Elmunzer, B. Joseph; Gosain, Sonia; Goldberg, Eric M.; Modayil, Rani J.; Stavropoulos, Stavros N.; Schembre, Drew B.; Di Maio, Christopher J.; Chandrasekhara, Vinay; Hasan, Muhammad K.; Varadarajulu, Shyam; Hawes, Robert; Gomez, Victoria; Woodward, Timothy A.; Rubel-Cohen, Sergio; Fluxa, Fernando; Vleggaar, Frank P.; Akshintala, Venkata S.; Raju, Gottumukkala S.; Khashab, Mouen A.

In: Gastrointestinal Endoscopy, Vol. 80, No. 4, 2015, p. 610-622.

Research output: Contribution to journalArticle

Haito-Chavez, Y, Law, JK, Kratt, T, Arezzo, A, Verra, M, Morino, M, Sharaiha, RZ, Poley, JW, Kahaleh, M, Thompson, CC, Ryan, MB, Choksi, N, Elmunzer, BJ, Gosain, S, Goldberg, EM, Modayil, RJ, Stavropoulos, SN, Schembre, DB, Di Maio, CJ, Chandrasekhara, V, Hasan, MK, Varadarajulu, S, Hawes, R, Gomez, V, Woodward, TA, Rubel-Cohen, S, Fluxa, F, Vleggaar, FP, Akshintala, VS, Raju, GS & Khashab, MA 2015, 'International multicenter experience with an over-the-scope clipping device for endoscopic management of GI defects (with video)', Gastrointestinal Endoscopy, vol. 80, no. 4, pp. 610-622. https://doi.org/10.1016/j.gie.2014.03.049
Haito-Chavez, Yamile ; Law, Joanna K. ; Kratt, Thomas ; Arezzo, Alberto ; Verra, Mauro ; Morino, Mario ; Sharaiha, Reem Z. ; Poley, Jan Werner ; Kahaleh, Michel ; Thompson, Christopher C. ; Ryan, Michele B. ; Choksi, Neel ; Elmunzer, B. Joseph ; Gosain, Sonia ; Goldberg, Eric M. ; Modayil, Rani J. ; Stavropoulos, Stavros N. ; Schembre, Drew B. ; Di Maio, Christopher J. ; Chandrasekhara, Vinay ; Hasan, Muhammad K. ; Varadarajulu, Shyam ; Hawes, Robert ; Gomez, Victoria ; Woodward, Timothy A. ; Rubel-Cohen, Sergio ; Fluxa, Fernando ; Vleggaar, Frank P. ; Akshintala, Venkata S. ; Raju, Gottumukkala S. ; Khashab, Mouen A. / International multicenter experience with an over-the-scope clipping device for endoscopic management of GI defects (with video). In: Gastrointestinal Endoscopy. 2015 ; Vol. 80, No. 4. pp. 610-622.
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abstract = "Background: The over-the-scope clip (OTSC) provides more durable and full-thickness closure as compared with standard clips. Only case reports and small case series have reported on outcomes of OTSC closure of GI defects. Objective: To describe a large, multicenter experience with OTSCs for the management of GI defects. Secondary goals were to determine success rate by type of defect and type of therapy and to determine predictors of treatment outcomes. Design: Multicenter, retrospective study. Setting: Multiple, international, academic centers. Patients: Consecutive patients who underwent attempted OTSC placement for GI defects, either as a primary or as a rescue therapy. Interventions: OTSC placement to attempt closure of GI defects. Main Outcome Measurements: Long-term success of the procedure. Results: A total of 188 patients (108 fistulae, 48 perforations, 32 leaks) were included. Long-term success was achieved in 60.2{\%} of patients during a median follow-up of 146 days. Rate of successful closure of perforations (90{\%}) and leaks (73.3{\%}) was significantly higher than that of fistulae (42.9{\%}) (P < .05). Long-term success was significantly higher when OTSCs were applied as primary therapy (primary 69.1{\%} vs rescue 46.9{\%}; P = .004). On multivariate analysis, patients who had OTSC placement for perforations and leaks had significantly higher long-term success compared with those who had fistulae (OR 51.4 and 8.36, respectively). Limitations: Retrospective design and multiple operators with variable expertise with the OTSC device. Conclusion: OTSC is safe and effective therapy for closure of GI defects. Clinical success is best achieved in patients undergoing closure of perforations or leaks when OTSC is used for primary or rescue therapy. Type of defect is the best predictor of successful long-term closure.",
author = "Yamile Haito-Chavez and Law, {Joanna K.} and Thomas Kratt and Alberto Arezzo and Mauro Verra and Mario Morino and Sharaiha, {Reem Z.} and Poley, {Jan Werner} and Michel Kahaleh and Thompson, {Christopher C.} and Ryan, {Michele B.} and Neel Choksi and Elmunzer, {B. Joseph} and Sonia Gosain and Goldberg, {Eric M.} and Modayil, {Rani J.} and Stavropoulos, {Stavros N.} and Schembre, {Drew B.} and {Di Maio}, {Christopher J.} and Vinay Chandrasekhara and Hasan, {Muhammad K.} and Shyam Varadarajulu and Robert Hawes and Victoria Gomez and Woodward, {Timothy A.} and Sergio Rubel-Cohen and Fernando Fluxa and Vleggaar, {Frank P.} and Akshintala, {Venkata S.} and Raju, {Gottumukkala S.} and Khashab, {Mouen A.}",
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T1 - International multicenter experience with an over-the-scope clipping device for endoscopic management of GI defects (with video)

AU - Haito-Chavez, Yamile

AU - Law, Joanna K.

AU - Kratt, Thomas

AU - Arezzo, Alberto

AU - Verra, Mauro

AU - Morino, Mario

AU - Sharaiha, Reem Z.

AU - Poley, Jan Werner

AU - Kahaleh, Michel

AU - Thompson, Christopher C.

AU - Ryan, Michele B.

AU - Choksi, Neel

AU - Elmunzer, B. Joseph

AU - Gosain, Sonia

AU - Goldberg, Eric M.

AU - Modayil, Rani J.

AU - Stavropoulos, Stavros N.

AU - Schembre, Drew B.

AU - Di Maio, Christopher J.

AU - Chandrasekhara, Vinay

AU - Hasan, Muhammad K.

AU - Varadarajulu, Shyam

AU - Hawes, Robert

AU - Gomez, Victoria

AU - Woodward, Timothy A.

AU - Rubel-Cohen, Sergio

AU - Fluxa, Fernando

AU - Vleggaar, Frank P.

AU - Akshintala, Venkata S.

AU - Raju, Gottumukkala S.

AU - Khashab, Mouen A.

PY - 2015

Y1 - 2015

N2 - Background: The over-the-scope clip (OTSC) provides more durable and full-thickness closure as compared with standard clips. Only case reports and small case series have reported on outcomes of OTSC closure of GI defects. Objective: To describe a large, multicenter experience with OTSCs for the management of GI defects. Secondary goals were to determine success rate by type of defect and type of therapy and to determine predictors of treatment outcomes. Design: Multicenter, retrospective study. Setting: Multiple, international, academic centers. Patients: Consecutive patients who underwent attempted OTSC placement for GI defects, either as a primary or as a rescue therapy. Interventions: OTSC placement to attempt closure of GI defects. Main Outcome Measurements: Long-term success of the procedure. Results: A total of 188 patients (108 fistulae, 48 perforations, 32 leaks) were included. Long-term success was achieved in 60.2% of patients during a median follow-up of 146 days. Rate of successful closure of perforations (90%) and leaks (73.3%) was significantly higher than that of fistulae (42.9%) (P < .05). Long-term success was significantly higher when OTSCs were applied as primary therapy (primary 69.1% vs rescue 46.9%; P = .004). On multivariate analysis, patients who had OTSC placement for perforations and leaks had significantly higher long-term success compared with those who had fistulae (OR 51.4 and 8.36, respectively). Limitations: Retrospective design and multiple operators with variable expertise with the OTSC device. Conclusion: OTSC is safe and effective therapy for closure of GI defects. Clinical success is best achieved in patients undergoing closure of perforations or leaks when OTSC is used for primary or rescue therapy. Type of defect is the best predictor of successful long-term closure.

AB - Background: The over-the-scope clip (OTSC) provides more durable and full-thickness closure as compared with standard clips. Only case reports and small case series have reported on outcomes of OTSC closure of GI defects. Objective: To describe a large, multicenter experience with OTSCs for the management of GI defects. Secondary goals were to determine success rate by type of defect and type of therapy and to determine predictors of treatment outcomes. Design: Multicenter, retrospective study. Setting: Multiple, international, academic centers. Patients: Consecutive patients who underwent attempted OTSC placement for GI defects, either as a primary or as a rescue therapy. Interventions: OTSC placement to attempt closure of GI defects. Main Outcome Measurements: Long-term success of the procedure. Results: A total of 188 patients (108 fistulae, 48 perforations, 32 leaks) were included. Long-term success was achieved in 60.2% of patients during a median follow-up of 146 days. Rate of successful closure of perforations (90%) and leaks (73.3%) was significantly higher than that of fistulae (42.9%) (P < .05). Long-term success was significantly higher when OTSCs were applied as primary therapy (primary 69.1% vs rescue 46.9%; P = .004). On multivariate analysis, patients who had OTSC placement for perforations and leaks had significantly higher long-term success compared with those who had fistulae (OR 51.4 and 8.36, respectively). Limitations: Retrospective design and multiple operators with variable expertise with the OTSC device. Conclusion: OTSC is safe and effective therapy for closure of GI defects. Clinical success is best achieved in patients undergoing closure of perforations or leaks when OTSC is used for primary or rescue therapy. Type of defect is the best predictor of successful long-term closure.

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