ENDOSCOPIC BAND LIGATION WITHOUT RESECTION OF SMALL-SIZED SUBMUCOSAL TUMOURS: RESULTS IN SHORT-MEDIUM FOLLOW-UP TERM OF A MULTICENTER PROSPECTIVE STUDY (BANDING-SMT)

Abstract Background and study aims Gastric antral vascular ectasia (GAVE) is a capillary-type vascular malformation of the gastric antrum, usually diagnosed endoscopically in patients presenting with iron deficiency anemia or gastrointestinal bleeding. While there is established evidence for treatment with thermal modalities, such as argon plasma coagulation (APC) therapy, more recent studies have shown endoscopic band ligation (EBL) to be safe and effective in achieving remission. Our study aimed to evaluate long-term outcomes of patients with GAVE who underwent EBL at our institution. Patients and methods We retrospectively reviewed data from 33 patients with GAVE who underwent esophagogastroduodenoscopy and EBL between September 2012 and July 2017 within our institution, looking primarily at clinical response, recurrence, and blood transfusion requirements. Results Clinical response was achieved in 27 patients (81.8%). Among responders, recurrence-free survival decreased with time from 88 % at 1 year to 44 % at 2 years. Thirteen patients (48.1 %) had recurrence of GAVE at a mean time of 18.2 months (range 4.7 – 51.8). The only predictor of recurrence was greater number of pre-procedure blood transfusions. Conclusion This is the first study to evaluate long-term response and recurrence in patients with GAVE after treatment with EBL and predictors of clinical response after initial endoscopic therapy have been identified. While we were able to demonstrate excellent remission achievement rates in our GAVE patients who had undergone EBL, close clinical follow-up is clearly required as almost 50 % will have recurrence at around 18 months.

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Myocardial preservation using celsior solution in cardiac transplantation: early results and 5-year follow-up of a multicenter prospective study of 70 cardiac transplantations

The Annals of Thoracic Surgery ◽

10.1016/s0003-4975(02)03424-0 ◽

2002 ◽

Vol 73 (5) ◽

pp. 1495-1499 ◽

Cited By ~ 36

Author(s):

Jean-Paul Remadi ◽

Olivier Baron ◽

Jean C Roussel ◽

Oussana Al Habash ◽

Michele Treilhaud ◽

...

Keyword(s):

Prospective Study ◽

Cardiac Transplantation ◽

Myocardial Preservation ◽

Early Results ◽

Multicenter Prospective Study

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Do Knee Osteoarthritis Patterns Affect Patient-Reported Outcomes in Total Knee Arthroplasty? Results From an International Multicenter Prospective Study With 3-Year Follow-Up

The Journal of Arthroplasty ◽

10.1016/j.arth.2020.08.033 ◽

2020 ◽

Author(s):

Veronique Vestergaard ◽

Yhan E. Colon Iban ◽

Andreas Kappel ◽

Christopher M. Melnic ◽

Hany Bedair ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Osteoarthritis ◽

Prospective Study ◽

Knee Arthroplasty ◽

Patient Reported Outcomes ◽

Patient Reported ◽

Total Knee ◽

Multicenter Prospective Study ◽

International Multicenter

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Ruptured abdominal aortic aneurysm: Six-year follow-up results of a multicenter prospective study

Journal of Vascular Surgery ◽

10.1016/s0741-5214(94)70015-x ◽

1994 ◽

Vol 19 (5) ◽

pp. 888-900 ◽

Cited By ~ 121

Author(s):

K.Wayne Johnston

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Prospective Study ◽

Ruptured Abdominal Aortic Aneurysm ◽

Abdominal Aortic ◽

Multicenter Prospective Study

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Long-term occlusion results with SILK flow diversion in 28 aneurysms: Do recanalizations occur during follow-up?

Interventional Neuroradiology ◽

10.1177/1591019915583119 ◽

2015 ◽

Vol 21 (3) ◽

pp. 300-310 ◽

Cited By ~ 14

Author(s):

Anastasios Mpotsaris ◽

Martin Skalej ◽

Oliver Beuing ◽

Bernd Eckert ◽

Daniel Behme ◽

...

Keyword(s):

Prospective Study ◽

Intracranial Aneurysms ◽

Flow Diverter ◽

Success Rates ◽

Imaging Data ◽

Complete Occlusion ◽

Complex Aneurysms ◽

Multicenter Prospective Study

Background and purpose The purpose of this article is to report on the long-term success rates of Silk flow-diverter (FD) treatment in a multicenter prospective study for the treatment of complex aneurysms. Methods Between May 2008 and January 2011, all consecutive patients featuring complex intracranial aneurysms eligible for FD treatment with the Silk in three neurovascular centers were included. Clinical and imaging data were assessed during hospitalization and follow-up. Results Five patients were initially asymptomatic, 20 patients showed various neurological symptoms. Twenty-eight FDs were implanted in 25 patients treating 28 aneurysms. The immediate procedure-related morbidity was 8% (two of 25), mortality 0%. One procedure-related death was observed during follow-up (in-stent thrombosis). Compared to the immediate result nearly two of three aneurysms improved during follow-up; all angiographically confirmed inflow changes took place within six months after treatment. Final anatomic outcome in 24 aneurysms of 22 patients comprised 14 (59%) with complete occlusion, seven (29%) with a neck remnant, two (8%) with residual filling <50%, none with residual filling >50% and one (4%) unchanged in comparison to its pretreatment status. Postinterventional recanalizations were seen in three of 13 (23%) aneurysms treated with FD alone; none were observed in 15 aneurysms treated with adjunctive coiling. Conclusion Anatomic presentation and location are key for successful FD treatment. The rate of successful occlusion increases during follow-up. Postinterventional monitoring for at least six months is paramount, as anatomic outcome is not reliably predictable and recanalizations may occur in initially completely occluded aneurysms.

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Endoscopic band ligation compared to thermal therapy for gastric antral vascular ectasia: A systematic review and meta-analysis

United European Gastroenterology Journal ◽

10.1177/2050640620975243 ◽

2020 ◽

pp. 205064062097524

Author(s):

Jean M Chalhoub ◽

Jalaluddin Umar ◽

Kevin Groudan ◽

Nour Hamadeh ◽

David J Desilets ◽

...

Keyword(s):

Adverse Events ◽

Confidence Interval ◽

Thermal Therapy ◽

Gastric Antral Vascular Ectasia ◽

Band Ligation ◽

Vascular Ectasia ◽

Transfusion Requirements ◽

Endoscopic Band Ligation ◽

The Mean

Background Gastric antral vascular ectasia is an infrequent cause of gastrointestinal-related blood loss manifesting as iron-deficiency anemia or overt gastrointestinal bleeding, and is associated with increased healthcare burdens. Endoscopic therapy of gastric antral vascular ectasia most commonly involves endoscopic thermal therapy. Endoscopic band ligation has been studied as an alternative therapy with promising results in gastric antral vascular ectasia. Aims The primary aim was to compare the efficacy of endoscopic band ligation and endoscopic thermal therapy by argon plasma coagulation for the management of bleeding gastric antral vascular ectasia in terms of the mean post-procedural transfusion requirements and the mean hemoglobin level change. Secondary outcomes included a comparison of the number of sessions needed for cessation of bleeding, the change in transfusion requirements, and the adverse events rate. Methods PubMed, Medline, SCOPUS, Google Scholar, and the Cochrane Controlled Trials Register were reviewed. Randomized controlled clinical trials and retrospective studies comparing endoscopic band ligation and endoscopic thermal therapy in bleeding gastric antral vascular ectasia, with a follow-up period of at least 6 months, were included. Statistical analysis was done using Review Manager. Results Our search yielded 516 papers. After removing duplicates and studies not fitting the criteria of selection, five studies including 207 patients were selected for analysis. Over a follow-up period of at least 6 months, patients treated with endoscopic band ligation had significantly lower post-procedural transfusion requirements (MD −2.10; 95% confidence interval (−2.42 − −1.77)) and a significantly higher change in the mean hemoglobin with endoscopic band ligation vs endoscopic thermal therapy (MD 0.92; 95% confidence interval (0.39 − 1.45)). Endoscopic band ligation led to a fewer number of required sessions (MD −1.15; 95% confidence interval (−2.30 − −0.01)) and a more pronounced change in transfusion requirements (MD −3.26; 95% confidence interval (−4.84 − −1.68)). There was no difference in adverse events. Conclusion Results should be interpreted cautiously due to the limited literature concerning the management of gastric antral vascular ectasia. Compared to endoscopic thermal therapy, endoscopic band ligation for the management of bleeding gastric antral vascular ectasia led to significantly lower transfusion requirements, showed a trend toward more remarkable post-procedural hemoglobin elevation, and a fewer number of procedures. Endoscopic band ligation may improve outcomes and lead to decreased healthcare burden and costs.

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Cryotherapy in addition to chemotherapy for palliation of inoperable esophageal cancer: A multicenter prospective study.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.4_suppl.342 ◽

2020 ◽

Vol 38 (4_suppl) ◽

pp. 342-342

Author(s):

Toufic Kachaamy ◽

Neil R. Sharma ◽

Rahul Pannala ◽

Jeffrey Weber ◽

Kimberly Gorsuch ◽

...

Keyword(s):

Esophageal Cancer ◽

Prospective Study ◽

Systemic Therapy ◽

Caloric Intake ◽

Outlet Obstruction ◽

Stage Iv ◽

High Rate ◽

Multicenter Prospective Study ◽

Eortc Qlq

342 Background: Palliation of dysphagia (Dys) in patients with inoperable esophageal cancer (EC) can be challenging. The major goal of palliation therapy is to improve patient’s quality of life (QoL) and Dys and allow adequate caloric intake. The most commonly used palliative modalities for Dys are radiation therapy (RT) and esophageal stenting. However, RT is limited by total dose and adverse events (AE) in patients receiving systemic therapy (ST), and stenting suffers from a high rate of AE including reflux and chest pain. A relatively new modality of liquid nitrogen endoscopic spray cryotherapy (cryo) has been reported in retrospective studies to improve Dys in patients receiving systemic therapy. We prospectively evaluated Dys and QoL of patients with inoperable EC undergoing cryo in addition to ST for palliation. Methods: A prospective multicenter study of 24 adult inoperable EC patients undergoing cryo and ST for palliation at 4 specialized cancer centers from Sep 2017 to Aug 2019. QoL was assessed using a modified EORTC QLQ-OES18 questionnaire (score 18 to 72, with higher scores indicating worse QoL). Dys was measured using a 4-point Likert scale: 0, no Dys; 1, Dys to solids; 2, Dys to semi-solids; 3, Dys to liquids; 4, Dys to saliva. Paired t-test was used to evaluate change in QoL and Dys between pre- and post-cryo. Results: There were 19 males and 5 females (17 stage IV, 5 stage III, and 2 stage II at diagnosis). Among 24 patients, a total of 71 cryo were performed, with a mean of 2.9 treatments per patient. After a median follow-up of 2 months, the mean EORTC score improved significantly from 35.4 at baseline to 25.5 at last follow-up ( p < 0.001). Similarly, the Dys score improved significantly from 2.0 at baseline to 0.87 at last follow-up ( p < 0.001). Grade 3 or higher AE were seen in only one patient (4%) who had GI bleeding 2 weeks after cryo and was diagnosed with bleeding from severe reflux esophagitis related to gastric outlet obstruction. Conclusions: The analysis of this multicenter prospective study shows that cryo in addition to ST for palliation of EC is well tolerated with significant improvement in Dys and QoL.

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