Secondary outcomes
epistaxis, hemorrhage, stenosis, defect enlargement
ADVERSE EVENTS, HEMORRHAGE, CAVITY, EPISTAXIS, STENOSIS
Successful defect closure with EVT only was reached in 19/27 patients (70 %, 95 %CI 53–88). Additional treatment modalities were used in five patients. In one of the five patients, additional treatment was required owing to an inadequately collapsing cavity with EVT, and a muscle flap was subsequently placed into the cavity. After placement of the muscle flap, EVT was continued, resulting in successful closure of the defect. In four patients, a stent was placed after treatment and improvement of the defect with EVT, and left in situ for 1–4 weeks. In one patient, placement of a stent was decided because the sponge was dislodged repeatedly due to stenosis. In three other cases, the stent was placed over the small remaining defect at the discretion of the endoscopist in order to complete the last part of the treatment. Upon stent removal, all defects had closed successfully.Endoscopic through-the-scope (TTS) clips were initially used in three patients and remained in situ for 1–5 days. However, due to insufficient treatment with TTS clips alone, EVT was initiated. Therefore, these cases were considered as being treated with EVT only.All-cause mortality was 11 % (3/27, 95 %CI 2–29). Apart from the two aforementioned patients who died, a further patient died 8 days after completion of successful EVT, most likely due to a cardiac cause.Two moderate adverse events occurred (7 %, 95 %CI 1–24): one defect enlargement caused by the scope during sponge exchange, and one hemorrhage during sponge removal, requiring blood transfusion. Two incidents occurred (7 %, 95 %CI 1–24): a small laceration at the site of the sponge during removal and epistaxis due to the sponge tube.