Endoscopic treatment with argon plasma coagulation for portal hypertensive gastropathy with no response to pharmacological therapy

González-Suárez, Begoña; Monfort, David; Piqueras, Marta; Planella, Montserrat; Ancos-Aracil, C.L. de; Gallego, Ana Monzó; Torras, Xavier; López-Balaguer, J.M.; Villanueva, Cecilia E.; Balanzó, J.

doi:10.1016/s0168-8278(03)80601-3

Cited by 4 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results were found to be close to Abd El-Ghany et al [25] who reported that the mean Hb pre-APC was 8.3 ± 1.1, which gradually elevated to become 10.72 ± 1.54, this elevation showed significance throughout treatment follow-up. Moreover, our results do agree with that reported by Gonzalez-Suarez et al [7] that studied the effect of APC on bleeding from PHG, where out of 22 cirrhotic patients, 16 patients had PHG with chronic anemia and 6 patients had PHG with acute bleeding episode. APC was applied to the area of PHG.…”

Section: Discussionsupporting

confidence: 93%

“…They should be continued on a long-term basis because discontinuing the drug frequently leads to recurrence of bleeding [16]. APC is an effective and safe method to stop bleeding in patients with PHG [7]. Our results revealed that most common cause of liver disease was HCV infection either alone or associated with bilharziasis.…”

Section: Discussionmentioning

confidence: 66%

“…This is achieved by a noncontact thermal coagulation in which high-frequency current is applied to the target tissue through an argon plasma jet creating effective hemostasis and a homogenous surface coagulation with a limited penetration depth. It was reported that the hemoglobin (Hb) value improved and transfusion requirements decreased in patients with PHG after therapy with APC [7]. Conventionally, the nonselective α-/β-blocker, propranolol has been used to lower portal pressure and to avoid variceal rupture and consequent hematemesis.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Efficacy of Argon Plasma Coagulation versus Carvedilol for Treatment of Portal Hypertensive Gastropathy

2019

View full text Add to dashboard Cite

Background/Aim: Several treatment options have been developed for portal hypertensive gastropathy (PHG); medications and endoscopic management. The aim of this study was to evaluate the efficacy and safety of argon plasma coagulation (APC) versus Carvedilol in treatment of a cohort of Egyptian patients with severe PHG. Methods: A total of 130 patients with severe PHG were enrolled; 10 patients were excluded due to death and failure to complete the treatment sessions accordingly, 120 patients were included. Patients were divided into 2 groups: Group A (n = 52) treated with APC; Group B (n = 68) treated with oral Carvedilol. Success was defined as stabilization of hemoglobin (Hb) over 100 g/ dL or Hb increase > 10% from pretreatment level and reduction of blood transfusion requirements over the following 3 months after the start of therapy. Upper gastrointestinal endoscopy was performed to assess the degree and site of PHG. APC was conducted to areas with mucosal ectatic vascular lesions. Results: PHG was mostly fundic (36.35%) in APC group and (36.76%) in Carvedilol group (p = 0.56). Throughout follow-up period, there was significant increase in Hb level, serum iron, and serum ferritin with a significant decrease in total iron-binding capacity (TIBC) in APC group as compared to Carvedilol group (p < 0.001). Additionally, there was gradual increase in the mean Hb, serum iron, and serum ferritin and gradual decrease of TIBC in Carvedilol group. Accordingly, there was an overall improvement of iron deficiency anemia (IDA) in both groups; however, it was significantly better in APC group than in Carvedilol group. No major adverse events were detected in both the groups. Conclusion: APC significantly improves IDA and decreases transfusion requirements in patients with severe PHG as compared to oral Carvedilol with small risk of adverse events. Furthermore, the combination of APC and Carvedilol unless contraindicated could have a synergistic effect in controlling severe PHG.