TY - JOUR
T1 - Radiofrequency ablation for refractory gastric antral vascular ectasia (with video)
AU - McGorisk, Tim
AU - Krishnan, Kumar
AU - Keefer, Laurie
AU - Komanduri, Srinadh
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2013/10
Y1 - 2013/10
N2 - Background: Gastric antral vascular ectasia (GAVE) is a cause of upper GI bleeding and chronic anemia. Although upper endoscopy with argon plasma coagulation (APC) is an accepted therapy for GAVE, many patients continue to bleed and remain transfusion dependent after therapy. Radiofrequency ablation (RFA) may provide an alternative therapeutic option for GAVE. Objective: To determine the efficacy and safety of RFA for patients with GAVE who remain transfusion dependent after APC treatment. Design: Open-label prospective cohort study of patients with GAVE refractory to APC. Setting: Academic tertiary referral center. Patients: GAVE patients with previous failed APC therapy, chronic anemia, and transfusion dependence. Interventions: Endoscopic RFA to the gastric antrum using the HALO90 ULTRA ablation catheter until transfusion independence is achieved or a maximum of 4 sessions are performed. Main Outcome Measurements: Transfusion requirements before and after RFA. Secondary outcomes are hemoglobin before and 6 months after RFA completion, number of RFA sessions, and complications. Results: Twenty-one patients underwent at least 1 RFA session with ablation of GAVE lesions. At 6 months after completion of the course of RFA therapy, 18 of 21 patients (86%) were transfusion independent. Mean hemoglobin increased from 7.8 to 10.2 in responders (n = 18). Two adverse events occurred (minor acute bleeding and superficial ulceration); both resolved without intervention. Limitations: Single-center, single-operator, and nonrandomized design. Conclusions: RFA is safe and effective for treating patients with refractory GAVE after attempted APC.
AB - Background: Gastric antral vascular ectasia (GAVE) is a cause of upper GI bleeding and chronic anemia. Although upper endoscopy with argon plasma coagulation (APC) is an accepted therapy for GAVE, many patients continue to bleed and remain transfusion dependent after therapy. Radiofrequency ablation (RFA) may provide an alternative therapeutic option for GAVE. Objective: To determine the efficacy and safety of RFA for patients with GAVE who remain transfusion dependent after APC treatment. Design: Open-label prospective cohort study of patients with GAVE refractory to APC. Setting: Academic tertiary referral center. Patients: GAVE patients with previous failed APC therapy, chronic anemia, and transfusion dependence. Interventions: Endoscopic RFA to the gastric antrum using the HALO90 ULTRA ablation catheter until transfusion independence is achieved or a maximum of 4 sessions are performed. Main Outcome Measurements: Transfusion requirements before and after RFA. Secondary outcomes are hemoglobin before and 6 months after RFA completion, number of RFA sessions, and complications. Results: Twenty-one patients underwent at least 1 RFA session with ablation of GAVE lesions. At 6 months after completion of the course of RFA therapy, 18 of 21 patients (86%) were transfusion independent. Mean hemoglobin increased from 7.8 to 10.2 in responders (n = 18). Two adverse events occurred (minor acute bleeding and superficial ulceration); both resolved without intervention. Limitations: Single-center, single-operator, and nonrandomized design. Conclusions: RFA is safe and effective for treating patients with refractory GAVE after attempted APC.
KW - APC
KW - CS
KW - GAVE
KW - RFA
KW - argon plasma coagulation
KW - clinical success
KW - gastric antral vascular ectasia
KW - radiofrequency ablation
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U2 - 10.1016/j.gie.2013.04.173
DO - 10.1016/j.gie.2013.04.173
M3 - Article
C2 - 23660565
AN - SCOPUS:84884417688
SN - 0016-5107
VL - 78
SP - 584
EP - 588
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
IS - 4
ER -