Endoscopic treatment for gastric antral vascular ectasia

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Peng M.; Guo X.; Yi F.; Shao X.; Wang L.; Wu Y.; Wang C.; Zhu M.; Bian O.; Ibrahim M.; Chawla S.; Qi X.

Journal: Therapeutic Advances in Chronic Disease

Publisher: SAGE Publications Ltd

Publication Date: 12 August 2021

Volume / Issue: Volume 12

ISSN: 20406223

DOI: 10.1177/20406223211039696

Scopus: View on Scopus

Document Type: Review

Access: All Open Access; Gold Open Access; Green Open Access

Authors and Affiliations

Peng M., Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, China; Guo X., Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, China; Yi F., Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, China; Shao X., Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, China; Wang L., Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, China; Wu Y., Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, China; Wang C., Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, China; Zhu M., Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, China; Bian O., Department of No, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, China; Ibrahim M., Department of Gastroenterology and Hepatology, Theodor Bilharz Research Institute, Cairo, Egypt; Chawla S., Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA, United States; Qi X., Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang, 110840, Liaoning, China

Abstract

Gastric antral vascular ectasia (GAVE) is one of the uncommon causes of upper gastrointestinal bleeding. Major treatment of GAVE includes pharmacotherapy, endoscopy, and surgery. The efficacy and safety of pharmacotherapy have not been sufficiently confirmed; and surgery is just considered when conservative treatment is ineffective. By comparison, endoscopy is a common treatment option for GAVE. This paper reviews the currently used endoscopic approaches for GAVE, mainly including argon plasma coagulation (APC), radiofrequency ablation (RFA), and endoscopic band ligation (EBL). It also summarizes their efficacy and procedure-related adverse events. The endoscopic success rate of APC is 40–100%; however, APC needs several treatment sessions, with a high recurrence rate of 10–78.9%. The endoscopic success rates of RFA and EBL are 90–100% and 77.8–100%, respectively; and their recurrence rates are 21.4–33.3% and 8.3–48.1%, respectively. Hyperplastic gastric polyps and sepsis are major adverse events of APC and RFA; and Mallory–Weiss syndrome is occasionally observed after APC. Adverse events of EBL are rare and mild, such as nausea, vomiting, esophageal or abdominal pain, and hyperplastic polyps. APC is often considered as the first-line choice of endoscopic treatment for GAVE. RFA and EBL have been increasingly used as alternatives in patients with refractory GAVE. A high recurrence of GAVE after endoscopic treatment should be fully recognized and cautiously managed by follow-up endoscopy. In future, a head-to-head comparison of different endoscopic approaches for GAVE is warranted. © The Author(s), 2021.

Keywords

argon plasma coagulation; endoscopic band ligation; gastric antral vascular ectasia; radiofrequency ablation; abdominal pain; blood transfusion; clinical effectiveness; colonoscopy; comparative effectiveness; conservative treatment; cryotherapy; endoscopic surgery; endoscopic variceal ligation; endoscopy; esophagogastroduodenoscopy; esophagus pain; follow up; gastrointestinal hemorrhage; human; hyperplastic gastric sepsis; Mallory Weiss syndrome; nausea and vomiting; randomized controlled trial (topic); recurrence risk; recurrent disease; Review; sepsis; stomach antrum vascular ectasia; stomach mucosa; stomach polyp

Citation Information

Scopus Citations: 30

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