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Article Type

Original Study

Abstract

Background Gastric antral vascular ectasia (GAVE) is characterized by mucosal and submucosal vascular ectasia. It may present with iron-deficiency anemia or gastrointestinal bleeding. Argon plasma coagulation (APC) may be used for treating GAVE. This study aims to evaluate the efficacy and safety of APC in the treatment of GAVE. Patients and methods A total of 30 patients with GAVE and in need of treatment for bleeding or anemia were treated with APC every 2 to 4 weeks until eradication of GAVE or cessation of the patient's initial symptoms. They were then followed up on a monthly basis for recurrence of initial symptoms or blood transfusion and measurement of hemoglobin levels. Follow-up endoscopy was done after 6 months. Results Among the thirty patients who were included in the study, GAVE was associated with underlying cirrhosis in 18 (60%) patients. Indications for treatment were hematemesis and/or melena in 16 (53.3%) patients and iron-deficiency anemia in 14 (46.6%) patients. A total of 78 APC sessions were conducted for the treatment of GAVE (2.6 sessions per patient, range: 1–6 sessions). Successful endoscopic eradication of GAVE was achieved in 11 of 30 patients (36.6%). Seventeen (56.6%) patients showed improvement in the severity of GAVE from endoscopic evaluation with cessation of the patient's initial symptoms, highly significant reduction of blood transfusion, and an improvement in hemoglobin levels (highly significant). Only two (6.6%) patients showed no improvement in the severity of GAVE from endoscopic evaluation with the continuation of the patient's initial symptoms (bleeding). No endoscopy-related adverse events were found during the study period. Conclusion Endoscopic APC is safe and effective in treating GAVE with a significant reduction in the need for blood transfusion and an improvement in hemoglobin levels, but endoscopic eradication rate of GAVE is low (36.6%).

Keywords

Anemia, argon plasma coagulation, cirrhosis, gastric antral vascular ectasia, gastric fundal vascular ectasia

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