For high-risk ulcer bleeding requiring early anticoagulant resumption, what endoscopic/clinical threshold prompts you to add adjunctive prophylactic hemostatic powder specifically to support earlier restart?

If there is a high-risk ulcer, I would treat it as indicated. If, at the end of treatment (whether with injection + thermal therapy/ clips, etc), I am not confident that I rendered effective treatment, then I would apply hemostatic powder.

When I’m faced with a patient with a serious bleeding condition, whether it be an ulcer or other G.I. problem, I feel free to inject and clip or use the argon plasma coagulator. If bleeding varices, I’m particularly worried about rebleeds, so I will band and often use other modalities. In terms of r...