Band ligation of gastric antral vascular ectasia is a safe and effective endoscopic treatment

2012 ◽  
Vol 25 (4) ◽  
pp. 392-396 ◽  
Author(s):  
John Keohane ◽  
Wael Berro ◽  
Gavin C Harewood ◽  
Frank E Murray ◽  
Stephen E Patchett
Keyword(s):  
Endoscopic Treatment ◽  
Gastric Antral Vascular Ectasia ◽  
Band Ligation ◽  
Vascular Ectasia

scholarly journals Long-term follow-up in patients with gastric antral vascular ectasia (GAVE) after treatment with endoscopic band ligation (EBL)

2019 ◽  
Vol 07 (12) ◽  
pp. E1624-E1629 ◽  
Author(s):  
John Eccles ◽  
Vanessa Falk ◽  
Aldo J. Montano-Loza ◽  
Sergio Zepeda-Gómez
Keyword(s):  
Clinical Response ◽  
Argon Plasma Coagulation ◽  
Deficiency Anemia ◽  
Gastric Antral Vascular Ectasia ◽  
Band Ligation ◽  
Vascular Ectasia ◽  
Transfusion Requirements ◽  
Endoscopic Band Ligation

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.

Argon plasma coagulation (APC) : An effective endoscopic treatment of bleeding gastric antral vascular ectasia (GAVE)

2000 ◽  
Vol 118 (4) ◽  
pp. A463
Author(s):  
Frederic Oberti ◽  
Vincent Croquet ◽  
Mehdi Kaassis ◽  
Eric Vuillemin ◽  
Mene Zua ◽  
...  
Keyword(s):  
Endoscopic Treatment ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Gastric Antral Vascular Ectasia ◽  
Plasma Coagulation ◽  
Vascular Ectasia

scholarly journals Endoscopic treatment for gastric antral vascular ectasia

2021 ◽  
Vol 12 ◽  
pp. 204062232110396
Author(s):  
Mengyuan Peng ◽  
Xiaozhong Guo ◽  
Fangfang Yi ◽  
Xiaodong Shao ◽  
Le Wang ◽  
...  
Keyword(s):  
Adverse Events ◽  
Endoscopic Treatment ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
High Recurrence Rate ◽  
Gastric Antral Vascular Ectasia ◽  
Success Rates ◽  
Recurrence Rates ◽  
Vascular Ectasia ◽  
Major Treatment

Gastric antral vascular ectasia (GAVE) is one of the uncommon causes of upper gastrointestinal bleeding. Major treatment of GAVE includes pharmacotherapy, endoscopy, and surgery. The efficacy and safety of pharmacotherapy have not been sufficiently confirmed; and surgery is just considered when conservative treatment is ineffective. By comparison, endoscopy is a common treatment option for GAVE. This paper reviews the currently used endoscopic approaches for GAVE, mainly including argon plasma coagulation (APC), radiofrequency ablation (RFA), and endoscopic band ligation (EBL). It also summarizes their efficacy and procedure-related adverse events. The endoscopic success rate of APC is 40–100%; however, APC needs several treatment sessions, with a high recurrence rate of 10–78.9%. The endoscopic success rates of RFA and EBL are 90–100% and 77.8–100%, respectively; and their recurrence rates are 21.4–33.3% and 8.3–48.1%, respectively. Hyperplastic gastric polyps and sepsis are major adverse events of APC and RFA; and Mallory–Weiss syndrome is occasionally observed after APC. Adverse events of EBL are rare and mild, such as nausea, vomiting, esophageal or abdominal pain, and hyperplastic polyps. APC is often considered as the first-line choice of endoscopic treatment for GAVE. RFA and EBL have been increasingly used as alternatives in patients with refractory GAVE. A high recurrence of GAVE after endoscopic treatment should be fully recognized and cautiously managed by follow-up endoscopy. In future, a head-to-head comparison of different endoscopic approaches for GAVE is warranted.

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

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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