P1974 - The X-Tack Endoscopic Helix Tacking System: A Single Tertiary Center Experience

Mohanad Awadalla, MD¹, Roberto Trasolini, MD², James Stones, MD³, Tyler Berzin, MD, FACG^1
1Beth Israel Deaconess Medical Center, Boston, MA; ²Brigham and Women's Hospital, Boston, MA; ³University of Manitoba, Winnipeg, MB, Canada

Introduction: The X-Tack endoscopic Helix Tacking System is a novel through-the-scope (TTS) endoscopic suturing device indicated for closure of large mucosal defects. Approved for use in the United States (US) in early 2021, limited data exists on the range of real-world indications and outcomes in clinical practie. This study aims to describe X-tack indications and outcomes at a large tertiary US hospital.

Methods: A retrospective chart review of all patients who underwent X-tack endoscopic suturing between June 2021 and June 2022 at Beth Israel Deaconess Medical Center in Boston, MA was undertaken. Data on patient demographics, indication for X-tack use, location of X-tack closure, anticoagulant/antiplatelet use, clinical and technical success, and adverse events were collected. Predictors of clinical success were determined using ANOVA and multiple regression models.

Results: A total of 43 patients were included in the study (Table 1). Mean age was 57.2 (SD 18.7 years and 21 (48.4%) were male. 74.4% of procedures were performed using monitored anesthesia care (MAC). Five patients (11.6 %) were on anticoagulation, and ten (23.3%) were taking antiplatelet medications. Only one X-Tack kit was required in the majority of cases (81.4%). Indication for X-Tack closure included closure of fistula (30.2%), polypectomy defect (25.6%), GPOEM mucosotomy (20.9%), stent fixation (11.6%), and postoperative leak (9.3%). Supplemental closure was required in 17 patients (39.5%), and eight (18.6%) required re-interventions. A severe adverse event occurred in 1 patient (2.3%). Technical success was achieved in 39 patients (90.7%), while clinical success was achieved in 29 patients (67.4%). Mean follow up time was 36.4 days. No predictors of clinical success were identified.

Discussion: We report a large descriptive analysis of X-tack use at a large tertiary center with high technical success and moderate clinical success. Closure of fistulas, polypectomy defects and GPOEM mucostomy were the most common indications of use. Location, indication, age, antiplatelet use and anticoagulant use were not predictive of clinical success.


Disclosures:


Mohanad Awadalla, MD¹, Roberto Trasolini, MD², James Stones, MD³, Tyler Berzin, MD, FACG¹. P1974 - The X-Tack Endoscopic Helix Tacking System: A Single Tertiary Center Experience, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.