Recurrent gastric antral vascular ectasia: a single center experience

Area of Science:

• Gastroenterology
• Endoscopy
• Vascular Medicine

Background:

• Gastric antral vascular ectasia (GAVE) is an uncommon cause of upper gastrointestinal bleeding, accounting for approximately 4% of cases.
• GAVE is frequently associated with systemic conditions including liver cirrhosis, chronic kidney failure, autoimmune disorders, diabetes mellitus, hypothyroidism, and cardiovascular diseases.
• The exact etiopathogenesis of GAVE remains unclear and is a subject of ongoing research.

Purpose of the Study:

• To evaluate the safety and efficacy of endoscopic argon plasma coagulation (APC) in treating patients with gastric antral vascular ectasia (GAVE).
• To assess the long-term outcomes and need for further interventions following APC treatment for GAVE.

Main Methods:

• A retrospective review of GAVE cases treated at a digestive surgery unit.
• Nine patients with GAVE were identified and treated with endoscopic APC.
• Follow-up data for eight patients were analyzed after a median of 36 months.

Main Results:

• Endoscopic APC demonstrated safety and effectiveness in achieving hemostasis for bleeding vascular ectasia.
• Only one patient (11.1%) required surgical intervention due to hemodynamic instability after multiple failed endoscopic treatments.
• No intraoperative or postoperative complications or bleeding relapses were observed in the study cohort.

Conclusions:

• Endoscopic APC is a technically straightforward treatment for GAVE but may necessitate multiple re-interventions due to relapse.
• Larger randomized controlled trials are needed to evaluate the role of elective surgery as a primary intervention for stable patients with severe GAVE.
• Further research should also focus on determining the optimal timing for surgical intervention after failed endoscopic treatment.