Endoscopic hemostasis state of the art - Nonvariceal bleeding

Table 1 Overview on the commercially available substanced for topical application[5]

	Contains	Mechanism of action	Approved human application	Formulation
Ankaferd blood stopper	Herbal mixture	Forms protein networks, activates clotting cascade	Dental procedures, first aid services	Tampons, sprays, ampoules
Hemospray	Mineral powder	Absorbs H2O, mechanical tamponade, activates clotting cascade	Nonvariceal GI bleeding	CO2 pressurized handheld canister (20 g)
EndoClot	Absorbable polymere	Absorbs H2O and concentrate cells, activates clotting cascade	Adjuvant hemostatic therapy	Pressurized air compressor

GI: Gastrointestinal.

Table 2 Currently available through the scope clips for endoscopic hemostasis

Clip	Manufacturer	Opening with	Special
Clipmaster 3	Medwork, Höchstadt/Aisch, Germany	12 mm	3 clips in a row - no change of the applicator required
Quick clip 2	Olympus, Hamburg, Germany	9 mm	Multiple use applicator
Quick clip 2 long	Olympus, Hamburg, Germany	11 mm	Multiple use applicator
Resolution clip	Boston Scientific, Ratingen, Germany	11 mm	Reopenable after placement
Instinct clip	Cook Medical, Limerick, Ireland	16 mm	Reopenable after placement

With the clipmaster 3 clips can be applied with one applicator. The quick clip applicator is a multiple use device but every clip has to be separately loaded. The instinct and the resolution clip can be closed and reopened until a proper position could be achieved.