Eagle Claw II: a novel endosuture device that uses a curved needle for major arterial bleeding: a bench study

Background: Control of bleeding from major arteries in the upper-GI tract rmains difficult with currently available endoscopic devices. We designed an endososuture device that uses a knotting, and assessed the device in stopping arterial bleeding in a hench model. Methods: Harvested porcine splenic arteries (2-mm-diameter) were tunneled submucosally in pig stomach with the open end protruding into an artificially created mucosal deficite. The outer end of the vessel was connected to a pulsate pump, and red ink was infused at a pressure of about 100 mm Hg. The stomach was installed on an Erlangen endo-training model. The Suturing device (Eagle Claw II), mounted outside an endoscopic, has an eyed, curved needle that carries a 3-0 nylon thread. After puncture, the thread as retrieved by using a hook, Three-throw square knots were tied at the thread extracorporeally and were pushed into place by using at a knotting cap. The criteria of successful plication was defined as hemostasis after knotting, no leakage pressures of > 200 mm Hg, and the vessel was completely encircled by the suture. Results: A total of 25 Sutures were made with the mean time of 9,38 minutes (standard (deviation 1.51). Control of the bleeding was obtained with 17 Sutures (68%). The causes for failure were the following: a suture was too shallow (4), a loose knot (2), incorrect suture position (1), and stomach-wall edema (1). Conclusions: Control of bleeding from large arteries by using endoscopic suturing is possible. Continued refinements of the device are required.