Evidence map›Paper›PMID 36701035›Full record

ArticleIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2023

Effective, safe and efficient porcine model of Forrest Ib bleeding gastric and colonic ulcers.

Bachir Ghandour, Furqan A Bhullar, Daniel Szvarca, Michael Bejjani, Todd Brenner, Katherine McKee, Ayesha Kamal, Steven N Steinway, Mustafa Kamal, Ernesto Ricourt and 3 more

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Article in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 1 institution in 1 country.

Bachir GhandourDivision of Gastroenterology and Hepatology, Johns Hopkins Medicine, 600 N. Wolfe Street, Blalock 466, Baltimore, MD, 21205, USA.ORCID http://orcid.org/0000-0002-7303-7504
Furqan A BhullarDivision of Gastroenterology and Hepatology, Johns Hopkins Medicine, 600 N. Wolfe Street, Blalock 466, Baltimore, MD, 21205, USA.
Daniel SzvarcaDivision of Gastroenterology and Hepatology, Johns Hopkins Medicine, 600 N. Wolfe Street, Blalock 466, Baltimore, MD, 21205, USA.
Michael BejjaniDivision of Gastroenterology and Hepatology, Johns Hopkins Medicine, 600 N. Wolfe Street, Blalock 466, Baltimore, MD, 21205, USA.
Todd BrennerDivision of Gastroenterology and Hepatology, Johns Hopkins Medicine, 600 N. Wolfe Street, Blalock 466, Baltimore, MD, 21205, USA.
Katherine McKeeDivision of Gastroenterology and Hepatology, Johns Hopkins Medicine, 600 N. Wolfe Street, Blalock 466, Baltimore, MD, 21205, USA.
Ayesha KamalDivision of Gastroenterology and Hepatology, Johns Hopkins Medicine, 600 N. Wolfe Street, Blalock 466, Baltimore, MD, 21205, USA.
Steven N SteinwayDivision of Gastroenterology and Hepatology, Johns Hopkins Medicine, 600 N. Wolfe Street, Blalock 466, Baltimore, MD, 21205, USA.
Mustafa KamalDivision of Gastroenterology and Hepatology, Johns Hopkins Medicine, 600 N. Wolfe Street, Blalock 466, Baltimore, MD, 21205, USA.
Ernesto RicourtDivision of Gastroenterology and Hepatology, Johns Hopkins Medicine, 600 N. Wolfe Street, Blalock 466, Baltimore, MD, 21205, USA.
Vikesh K SinghDivision of Gastroenterology and Hepatology, Johns Hopkins Medicine, 600 N. Wolfe Street, Blalock 466, Baltimore, MD, 21205, USA.
Mouen A KhashabDivision of Gastroenterology and Hepatology, Johns Hopkins Medicine, 600 N. Wolfe Street, Blalock 466, Baltimore, MD, 21205, USA.
Venkata S AkshintalaDivision of Gastroenterology and Hepatology, Johns Hopkins Medicine, 600 N. Wolfe Street, Blalock 466, Baltimore, MD, 21205, USA. vakshin1@jhmi.edu.
Johns Hopkins University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDeveloping effective gastrointestinal (GI) bleeding animal models is necessary to advance endoscopic hemostasis methods and train endoscopists on their use. Our aim, therefore, was to develop an effective and safe porcine GI bleeding model in the stomach and colon of large and small-sized oozing-type ulcers.

methodsGastric and colonic bleeding ulcers were created using either a hybrid endoscopic submucosal dissection (ESD) technique or a cap-assisted endoscopic mucosal resection (EMR-C) technique in 14 pigs. Prior to ulcer creation, animals were treated with either oral apixaban or intravenous (IV) unfractionated heparin anticoagulation in combination with clopidogrel and aspirin. The primary outcome was the technical success of inducing oozing-type Forrest Ib bleeding ulcers. Secondary outcomes included ulcer diameter, number, creation time and the number of complications associated with each technique.

resultsUsing hybrid ESD and IV heparin anticoagulation, bleeding was observed in 21/23 (91.3%) gastric ulcers and 6/7 (85.7%) colonic ulcers created. The mean diameter and ulcer creation time were 2.3 ± 0.3 cm and 5.3 ± 0.5 min, respectively, for gastric ulcers and 2.2 ± 0.4 cm and 4.06 ± 0.6 min, respectively, for colonic ulcers. Using EMR-C and IV heparin anticoagulation, bleeding was observed in 14/15 (93.3%) gastric ulcers and 6/6 (100%) colonic ulcers created. The mean diameter and ulcer creation time were 0.8 ± 0.2 cm and 2.1 ± 0.5 min, respectively, for gastric ulcers and 0.7 ± 0.2 cm and 1.7 ± 0.3 min, respectively, for colonic ulcers. None of the ulcers created in animals anticoagulated with apixaban developed bleeding. None of the 14 pigs developed any complications.

conclusionWe have demonstrated the effectiveness and safety of a porcine GI bleeding model utilizing IV heparin anticoagulation and either hybrid ESD or EMR-C techniques to create oozing-type bleeding ulcers in the stomach and colon with customizable size.

Indexed as

Colonic DiseasesStomach NeoplasmsStomach UlcerAnimalsAnticoagulantsGastrointestinal HemorrhageHeparinSwineTreatment OutcomeUlcerAnticoagulantsHeparinAnimal modelBleeding modelCap-assisted endoscopic mucosal resectionEndoscopic submucosal dissectionLower gastrointestinal bleedingPorcine modelUpper gastrointestinal bleeding

Identifiers

PMID36701035
OpenAlexW4318066450

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.