S727 The X-Tack Endoscopic Helix Tacking System: A Single Tertiary Center Experience
Bibliographic record
Abstract
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. Conclusion: 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. Table 1. - *Severe Based on ASGE Criteria Descriptive Value Age Mean, years (sd) 57.21 (18.72) Sex, n (%) Male Female 21 (48.8)22 (51.1) Outpatient, n (%) 32 (74.4) Sedation RN MAC GA 0 (0)32 (74.4)11 (25.6) ASA 1 2 3 4 0 (0)19 (44.2)18 (41.9)6 (13.9) Procedure duration(mins), mean (SD) 70.51 (32.1) Anticoagulant use, n (%) 5 (11.6) Anticoagulant Warfarin Apixaban 1 (2.3)4 (9.3) Antiplatelet use, n (%) 10 (23.3) Indication Polypectomy defect closure Fistula closure Post-operative leak closure GPOEM mucosotomy closure Stent fixation Other 11 (25.6)13 (30.2)4 (9.3)9 (20.9)5 (11.6)1 (2.3) Polypectomy technique Snare EMR 8 (18.6)3 (7.0) X-Tack location Esophagus Stomach Small intestine Colon Rectum 5 (11.6)25 (58.1)2 (4.7)10 (23.3)1 (2.3) Number of X-Tack used 1 2 3 35 (81.4)3 (7.0)4 (9.3) Closure pattern Running Pursestring Z-pattern X-pattern Not reported 0 (0)0 (0)22 (51.1)2 (4.6)19 (44.2) Additional closure, n (%) 17 (39.5) Adverse events*, n (%) 1 (2.3) Technical success, n (%) 39 (90.7) Clinical success, n (%) 29 (67.4) Need for re-intervention, n (%) 8 (18.6) Follow up, n (%) 38 (88.4) Follow-up duration, days 36.4 (74.0)
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".