Refractory Gave Treated with Radiofrequency: Two Cases of Complete Response

Gastric antral vascular ectasia (GAVE) is an uncommon cause of upper gastrointestinal bleeding. Up to date, standard of care of GAVE is endoscopic treatment with argon plasma coagulation (APC) or endoscopic band ligation (EBL). Despite good technical efficacy of these techniques, approximately two third of patients remain dependent on blood transfusions after therapy. One of the emerging and more promising endoscopic treatments for GAVE is radiofrequency ablation (RFA) with focal catheters (e.g. HALO90 and HALOULTRA).

Author(s):  
Marcelo Aveiro ◽  
Tatiana Rodrigues ◽  
Tiago Rabadão ◽  
Filipa Ferreira ◽  
Mariana Teixeira ◽  
...  

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.


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