Band ligation of gastric antral vascular ectasia is a safe and effective endoscopic treatment

Keohane, John; Berro, Wael; Harewood, Gavin C.; Murray, Frank E.; Patchett, Stephen

doi:10.1111/j.1443-1661.2012.01410.x

Cited by 40 publications

(39 citation statements)

References 19 publications

(39 reference statements)

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“…Our study found that EBL had comparable safety and efficacy than APC. In agreement with these results, although they had fewer patients, Keohane et al 16 conclude in their retrospective study in 2013 that EBL is a safe and effective treatment of GAVE.…”

Section: Discussionsupporting

confidence: 71%

Randomized controlled study of endoscopic band ligation and argon plasma coagulation in the treatment of gastric antral and fundal vascular ectasia

Elhendawy

Mosaad

Alkhalawany

et al. 2015

United European Gastroenterology Journal

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Background: Gastric antral vascular ectasia (GAVE) is characterized by mucosal and submucosal vascular ectasia causing recurrent hemorrhage and thus, chronic anemia, in patients with cirrhosis. Treatment with argon plasma coagulation (APC) is an effective and safe method, but requires multiple sessions of endoscopic therapy. Endoscopic band ligation (EBL) was found to be a good alternative for APC as a treatment for GAVE, especially in refractory cases. The aim of this prospective randomized controlled study was to evaluate the safety and efficacy of EBL, as compared to APC, in the treatment of GAVE and gastric fundal vascular ectasia (GFVE). Patients and methods: A total of 88 cirrhotic patients with GAVE were prospectively randomized to endoscopic treatment with either EBL or APC, every 2 weeks until complete obliteration was accomplished; then they were followed up endoscopically after 6 months, plus they had monthly measurement of hemoglobin levels during that period. Results: We describe the presence of mucosal and submucosal lesions in the gastric fundal area that were similar to those found in GAVE in 13 patients (29.5%) of the EBL group and 9 patients (20.5%) of the APC group; we named this GFVE. In these cases, we treated the fundal lesions with the same techniques we had used for treating GAVE, according to the randomization. We found that EBL significantly decreased the number of sessions required for complete obliteration of the lesions (2.98 sessions compared to 3.48 sessions in the APC group (p < 0.05)). Hemoglobin levels increased significantly after obliteration of the lesions in both groups, compared to pretreatment values (p < 0.05), but with no significant difference between the two groups (p > 0.05); however, the EBL group of patients required a significantly smaller number of units of blood transfusion than the APC group of patients (p < 0.05). There were no significant differences in adverse events nor complications between the two groups (p > 0.05). Conclusions: This study described and histologically proved the presence of GFVE occurring comcomitantly with GAVE in cirrhotic patients. We showed that GFVE can be successfully managed by EBL or APC. Our study revealed that EBL is more effective and is comparable in safety to APC, in the treatment of GAVE and GFVE in cirrhotic patients.

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Section: Discussionsupporting

confidence: 71%

Randomized controlled study of endoscopic band ligation and argon plasma coagulation in the treatment of gastric antral and fundal vascular ectasia

Elhendawy

Mosaad

Alkhalawany

et al. 2015

United European Gastroenterology Journal

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“…The mainstay of treatment of GAVE is argon plasma coagulation, a thermoablative technique that is applied via endoscopy. Some literature now also advocate the use of EVL in the treatment of portal hypertension-related GAVE, 48 In cases of acute hemorrhage, the approach is similar to that of other upper GI bleeding in patients with advanced liver disease ( Table 1).…”

Section: Olson and Saeianmentioning

confidence: 96%

Gastrointestinal Issues in Liver Disease

Olson

Saeian

2016

Critical Care Clinics

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“…La cryothé rapie n'ayant pas semblé indiqué e, les traitements ont consisté en ligatures ou ré sections des ectasies, sclé rothé rapie (alcool, chaleur), é lectroré section, é lectro-coagulation bi-ou multipolaire, coagulation laser [1,[4][5][6][7][8]10,11,13,[21][22][23][24][31][32][33][34][35][36]. À ce jour, c'est essentiellement à la coagulation par plasma-argon [4,7,8,24,26,32,[35][36][37] qu'il est fait appel même si, pour parvenir à tarir la dé perdition sanguine, elle doit être souvent ré pé té e du fait de la diffusion des lé sions, comme chez notre patient, avec un intervalle de 4 à 8 semaines, sans exposer à d'importantes complications [8,31]. La gestion des ectasies par radiofré quence pourrait en devenir une alternative inté ressante [38].…”

Section: Le Watermelon Stomachunclassified