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Is Endoscopic Band Ligation a Superior Treatment Modality for Gastric Antral Vascular Ectasia Compared to Argon Plasma Coagulation?
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Neil Robert O’Morain, Helen O’Donovan, Caroline Conlon, Eileen Shannon, Diarmuid Manning, Eoin Slattery
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Clin Endosc 2021;54(4):548-554. Published online January 13, 2021
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DOI: https://doi.org/10.5946/ce.2020.236
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 Abstract
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- Background
/Aims: Gastric antral vascular ectasia (GAVE) is a rare acquired vascular lesion of the gastric antrum. The most frequent presentation of GAVE is iron deficiency anemia. Endoscopic therapy is the mainstay of treatment. However, there is no consensus regarding the optimal treatment modality.
Methods
A retrospective cohort study was performed on patients with GAVE, including patients receiving endoscopic therapy. Treatment was with either argon plasma coagulation (APC) or endoscopic band ligation (EBL). Basic demographic data, indication for index procedure, number of sessions, and pre- and post-hemoglobin levels were collected. The aim of the study was to compare outcomes across the two treatment modalities.
Results
One hundred and seventeen diagnoses of GAVE were made. Sixty-two patients (53%) required endoscopic treatment for symptomatic GAVE (female, n=38, 61%; mean age of 74.4 years). Two hundred and eighteen procedures were performed during the study period. APC was performed (n=161, 74%) more frequently than EBL (n=57, 26%). Patients treated with APC at index required a median 5 subsequent therapeutic interventions (APC or EBL), while those treated with EBL at index required a further 2.9 treatments (EBL only) (p<0.05).
Conclusions
APC was the most common treatment modality employed. We demonstrate an increasing incidence of EBL. Patients treated with EBL at index treatment required fewer subsequent treatment sessions and had a greater mean rise in hemoglobin. This suggests a more effective endoscopic response with EBL.
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Citations
Citations to this article as recorded by  - Role of Endoscopy in the Diagnosis, Grading, and Treatment of Portal Hypertensive Gastropathy and Gastric Antral Vascular Ectasia
Ali Khalifa, Don C. Rockey
Gastrointestinal Endoscopy Clinics of North America.2024; 34(2): 263. CrossRef - Snare-tip spray spark coagulation technique for bleeding secondary to gastric antral vascular ectasia
Koudai Hamaguchi, Tatsuma Nomura, Keiichi Ito, Makoto Kobayashi
Endoscopy.2022; 54(10): E562. CrossRef - Gastric Antral Vascular Ectasia (GAVE) a case report, review of the literature and update of techniques
L. Fortuna, A. Bottari, D. Bisogni, F. Coratti, F. Giudici, B. Orlandini, G. Dragoni, F. Cianchi, F. Staderini
International Journal of Surgery Case Reports.2022; 98: 107474. CrossRef - Endoscopic band ligation in the treatment of gastric antral vascular ectasia: a systematic review and meta-analysis
Babu P. Mohan, Gregory Toy, Lena L. Kassab, Suresh Ponnada, Saurabh Chandan, Sheeva Parbhu, Shaun Chandna, Douglas G. Adler
Gastrointestinal Endoscopy.2021; 94(6): 1021. CrossRef
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