Hemospray as Rescue Therapy in Failed Endotherapy in a Patient on Dual Antiplatelet Therapy

Introduction: Upper gastrointestinal (UGI) bleeding secondary to peptic ulcer disease is a common medical condition that results in high patient morbidity. While in majority of patients with bleeding peptic ulcers bleeding will stop spontaneously. A subgroup of patients include heavy drinkers, regular use of dual antiplatelets, smoking cigarettes or chewing tobacco, being very ill, radiation treatments, and stress needs pharmacological and endoscopic intervention. Although several types of endoscopic treatment for bleeding peptic ulcers have been described, including injection therapy, thermal coagulation, the application of various types of through-the-scope (TTS) or over-the-scope clips (OTSC) hemoclips, fibrin sealant (or glue), argon plasma coagulation, and combination therapy (typically injection of epinephrine combined with another treatment modality). Despite advances in pharmacologic and endoscopic therapy, mortality rates have not improved