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.

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 The Use of Thalidomide in Severe Refractory Anaemia Due to Gastric Antral Vascular Ectasia (GAVE) in Cirrhosis?

2020 ◽  
Author(s):  
Marcelo Aveiro ◽  
Tatiana Rodrigues ◽  
Tiago Rabadão ◽  
Filipa Ferreira ◽  
Mariana Teixeira ◽  
...  
Keyword(s):  
Upper Gastrointestinal Bleeding ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
High Recurrence Rate ◽  
Gastric Antral Vascular Ectasia ◽  
Refractory Anaemia ◽  
First Line ◽  
Vascular Ectasia ◽  
Recent Diagnosis ◽  
Upper Gastrointestinal

Gastric antral vascular ectasia (GAVE) is a rare cause of upper gastrointestinal bleeding associated with cirrhosis. The first-line treatment is endoscopic therapy with argon plasma coagulation (APC). There is a high recurrence rate, but some evidence suggests that thalidomide could play an important role in controlling refractory anaemia due to GAVE. The authors present the case of a cirrhotic patient with a recent diagnosis of GAVE, who underwent multiple endoscopic treatments and blood transfusions because of haematemesis. The patient started thalidomide and 6 months later, there was no recurrence of haematemesis and haemoglobin levels were stable, with no reported adverse effects.

scholarly journals Watermelon stomach: clinical aspects and treatment with argon plasma coagulation

2006 ◽  
Vol 43 (3) ◽  
pp. 191-195 ◽  
Author(s):  
Dalton M. Chaves ◽  
Paulo Sakai ◽  
Cláudio V. Oliveira ◽  
Spencer Cheng ◽  
Shinichi Ishioka
Keyword(s):  
Liver Disease ◽  
Endoscopic Treatment ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Gastric Antral Vascular Ectasia ◽  
Plasma Coagulation ◽  
Vascular Ectasia ◽  
Group 2 ◽  
Group 1

BACKGROUND: Gastric antral vascular ectasia is a disorder whose pathogenetic mechanism is unknown. The endoscopic treatment with argon plasma coagulation has been considered one of the best endoscopic therapeutic options. AIM: To analyze the endoscopic and clinical features of gastric antral vascular ectasia and its response to the argon plasma coagulation treatment. PATIENTS AND METHODS: Eighteen patients were studied and classified into two groups: group 1 - whose endoscopic aspect was striped (watermelon) or of the diffuse confluent type; group 2 - diffuse spotty nonconfluent endoscopic aspect. RESULTS: Group 1 with eight patients, all having autoimmune antibodies, but one, whose antibodies were not searched for. Three were cirrhotic and three had hypothyroidism. All had gastric mucosa atrophy. In group 2, with 10 patients, all had non-immune liver disease, with platelet levels below 90.000. Ten patients were submitted to argon plasma coagulation treatment, with 2 to 36 months of follow-up. Lesions recurred in all patients who remained in the follow-up program and one did not respond to treatment for acute bleeding control. CONCLUSION: There seem to be two distinct groups of patients with gastric antral vascular ectasia: one related to immunologic disorders and other to non-immune chronic liver disease and low platelets. The endoscopic treatment using argon plasma coagulation had a high recurrence in the long-term evaluation.

scholarly journals Gastric Antral Vascular Ectasia Associated with Asymptomatic Mixed Connective Tissue Disease Refractory to Endoscopic Treatment: A Rare Case

2020 ◽  
Vol 3 (2) ◽  
pp. 40-45
Author(s):  
Muhammed Jasim Abdul Jalal ◽  
K.M. Mohammed Iqbal ◽  
Roy J. Mukkada ◽  
Rashmi Ratnakaran ◽  
Shani Basheer
Keyword(s):  
Connective Tissue ◽  
Connective Tissue Disease ◽  
Endoscopic Treatment ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Iron Level ◽  
Gastric Antral Vascular Ectasia ◽  
Serum Iron Level ◽  
Vascular Ectasia ◽  
Upper Gi

Gastric antral vascular ectasia (GAVE) constitutes 4% of all nonvariceal upper GI bleedings. It is characterized by the presence of erythematous or hemorrhagic ectatic vessels within the antrum that are distributed either in a striped or diffuse punctate pattern. We report a 64-year-old female without any co-morbidities, who presented with multiple episodes of blood in stools. Laboratory studies revealed a hemoglobin level of 5 g/dL with a hematocrit of 18.3%. Iron studies revealed a serum iron level of 35 μg/dL. She underwent an upper GI endoscopy, and biopsy was consistent with gastric antral vascular ectasia. ANA (antinuclear antibody), RA (rheumatoid factor), and anti-centromere antibody were all strongly positive. Erythrocyte sedimentation rate was 56. She was asymptomatic as far as connective tissue disease was concerned. Her anemia improved, but argon plasma coagulation failed to sustain the suppression of GAVE, and she required a blood transfusion for severe anemia on two occasions. With regard to recurrent episodes of melena, she was started on oral methyl prednisolone in a tapering dosage. She improved with medications, and her hemoglobin is maintained at 11.3 g/dL. This is the first unique case of GAVE in a patient without any other systemic illness or portal hypertension refractory to endoscopic treatment responding to monotherapy with corticosteroids.

scholarly journals Endoscopic band ligation in the treatment of gastric antral vascular ectasia: a systematic review and meta-analysis

2021 ◽  
Vol 09 (07) ◽  
pp. E1145-E1157
Author(s):  
Thomas R. McCarty ◽  
Kelly E. Hathorn ◽  
Walter W. Chan ◽  
Kunal Jajoo
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Argon Plasma Coagulation ◽  
Meta Analysis ◽  
Argon Plasma ◽  
Mean Difference ◽  
Gastric Antral Vascular Ectasia ◽  
Band Ligation ◽  
Vascular Ectasia ◽  
Endoscopic Band Ligation

Abstract Background and study aims While argon plasma coagulation (APC) is the first-line treatment for gastric antral vascular ectasia (GAVE), endoscopic band ligation (EBL) has shown promising results. The aim of this study was to perform a systematic review and meta-analysis to evaluate the effectiveness of EBL for the treatment of GAVE. Methods Individualized search strategies were developed in accordance with PRISMA and MOOSE guidelines through September 1, 2020. Measured outcomes included endoscopic success (defined as GAVE eradication/improvement), change in hemoglobin, transfusion dependency, number of treatment sessions, adverse events, rebleeding, and bleeding-associated mortality. Outcomes were compared among studies evaluating EBL versus APC. Results Eleven studies (n = 393; 59.39 % female; mean age 58.65 ± 8.85 years) were included. Endoscopic success was achieved in 87.84 % [(95 % CI, 80.25 to 92.78); I2 = 11.96 %] with a mean number of 2.50 ± 0.49 treatment sessions and average of 12.40 ± 3.82 bands applied. For 8 studies comparing EBL (n = 143) versus APC (n = 174), there was no difference in baseline patient characteristics. However, endoscopic success was significantly higher for EBL [OR 6.04 (95 % CI 1.97 to 18.56; P = 0.002], requiring fewer treatment sessions (2.56 ± 0.81 versus 3.78 ± 1.17; P < 0.001). EBL was also associated with a greater increase in post-procedure hemoglobin [mean difference 0.35 (95 % CI 0.07 to 0.62; P = 0.0140], greater reduction in transfusions required [mean difference –1.46 (95 % CI –2.80 to –0.12; P = 0.033], and fewer rebleeding events [OR 0.11 (95 % CI, 0.04 to 0.36); P < 0.001]. There was no difference in adverse events or bleeding-associated mortality (P > 0.050). Conclusions EBL appears to be safe and effective for treatment of GAVE, with improved outcomes when compared to APC.

Endoscopic mucosal resection for recurrent gastric antral vascular ectasia

VASA ◽  
2008 ◽  
Vol 37 (3) ◽  
pp. 289-292 ◽  
Author(s):  
Katsinelos ◽  
Chatzimavroudis ◽  
Katsinelos ◽  
Panagiotopoulou ◽  
Kotakidou ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Deficiency Anemia ◽  
Gastric Antral Vascular Ectasia ◽  
Therapeutic Approaches ◽  
Plasma Coagulation ◽  
Vascular Ectasia ◽  
Mucosal Resection ◽  
First Case

Gastric antral vascular ectasia (GAVE) is an overt or occult source of gastrointestinal bleeding. Despite several therapeutic approaches have been successfully tested for preventing chronic bleeding, some patients present recurrence of GAVE lesions. To the best of our knowledge, we report the first case, of a 86-year-old woman who presented severe iron-deficiency anemia due to GAVE and showed recurrence of GAVE lesion despite the intensive argon plasma coagulation treatment. We performed endoscopic mucosal resection of bleeding GAVE with resolution of anemia.

scholarly journals Hyperplastic gastric polyps after argon plasma coagulation treatment of gastric antral vascular ectasia (GAVE)

Endoscopy ◽  
2007 ◽  
Vol 39 (S 1) ◽  
pp. E320-E320 ◽  
Author(s):  
J. Baudet ◽  
H. Salata ◽  
M. Soler ◽  
V. Castro ◽  
D. Díaz-Bethencourt ◽  
...  
Keyword(s):  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Gastric Antral Vascular Ectasia ◽  
Plasma Coagulation ◽  
Vascular Ectasia ◽  
Gastric Polyps
Sign in / Sign up

Export Citation Format

Share Document