Long‐acting octreotide as rescue therapy in chronic bleeding from gastrointestinal angiodysplasia

Scaglione, Giuseppe; Pietrini, L.; Russo, Filomena; Franco, MourãoGabriela; Sorrentini, I.

doi:10.1111/j.1365-2036.2007.03435.x

Cited by 70 publications

(84 citation statements)

References 34 publications

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“…Thalidomide, which blocks the action of vascular endothelial growth factor, seems to be also effective in these patients but further studies are required to confirm its effects (72). Finally, regarding hormonal therapies for the treatment of angiodysplasia, current evidence does not support their use (72).…”

Section: Angiodysplasiamentioning

confidence: 99%

“…Regarding medical therapy of angiodysplasia, the use of somatostatin analogues, namely octreotide administered by subcutaneous, intramuscular or intravenous routes, has been shown to significantly reduce rebleeding rates and transfusional requirements (73)(74)(75). Thalidomide, which blocks the action of vascular endothelial growth factor, seems to be also effective in these patients but further studies are required to confirm its effects (72). Finally, regarding hormonal therapies for the treatment of angiodysplasia, current evidence does not support their use (72).…”

Section: Angiodysplasiamentioning

confidence: 99%

“…Nevertheless, other interventions such as bipolar or heater probe electrocoagulation or band ligation have also been reported as successful in stopping bleeding from upper GI angiodysplasia (70,71 follow-up of about two years (72). In patients with recurrent or severe bleeding, as well as when endoscopic treatment is impossible (due to extensive involvement, difficult endoscopic access or comorbidities precluding invasive interventions), medical treatment of angiodysplasia should be considered.…”

Section: Angiodysplasiamentioning

confidence: 99%

See 2 more Smart Citations

New insights on an old medical emergency: non-portal hypertension related upper gastrointestinal bleeding

Cúrdia-Gonçalves¹,

Rosa²,

Cotter³

2016

Rev Esp Enferm Dig

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Upper gastrointestinal bleeding (UGIB) is a potentially life-threatening condition and the most common medical emergency managed by gastroenterologists. Despite being one of the most antique medical problems, recent studies have been slowly changing the management of these patients, which should nowadays include not only initial resuscitation, but also risk stratification, pre-endoscopic therapy, endoscopy treatment, and post-procedure care. The aim of this paper is to review the extended approach to the patient with non-portal hypertension related UGIB.

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Section: Angiodysplasiamentioning

confidence: 99%

Section: Angiodysplasiamentioning

confidence: 99%

Section: Angiodysplasiamentioning

confidence: 99%

See 1 more Smart Citation

New insights on an old medical emergency: non-portal hypertension related upper gastrointestinal bleeding

Cúrdia-Gonçalves¹,

Rosa²,

Cotter³

2016

Rev Esp Enferm Dig

View full text Add to dashboard Cite

show abstract

“…In the first study, 13 patients with chronic GI bleeding due to angiodysplasias were treated with octreotide LAR 10 mg per month and followed for at least 1 year. 19 Nine out of the thirteen patients (69%) did not require further blood or iron supplementation, and partial improvement was also observed in another patient. The second study addressed the response to octreotide LAR 20 mg per month in a cohort of 11 elderly patients with multiple comorbidities and severe OGIB, mostly related to small-bowel diffuse angiodysplasia (72%).…”

Section: Long-acting Release (Lar) Octreotidementioning

confidence: 99%

“…Published online 19 Endoscopy has had a major impact in the development of modern gastroenterology. By using different data it provided a better understanding of pathogenic mechanisms, described new entities and changed diagnostic and therapeutic strategies.…”

Section: Publisher Intechmentioning

confidence: 99%

Pharmacological Therapy for Recurrent Obscure Gastrointestinal Bleeding

Molina–Infante¹,

Vinagre-Rodríguez²,

Fernandez–Bermejo³

2011

Gastrointestinal Endoscopy

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Gastrointestinal Angiodysplasia Resolution After Transcatheter Aortic Valve Implantation

Goltstein,

Rooijakkers,

Thierens

et al. 2024

JAMA Netw Open

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ImportanceHeyde syndrome is the cooccurrence of aortic stenosis and gastrointestinal bleeding secondary to vascular lesions, including angiodysplasias. Several studies have demonstrated cessation of gastrointestinal bleeding after transcatheter aortic valve implantation (TAVI), but the etiology and effects on vascular lesions are largely unknown.ObjectiveTo examine the associations of TAVI with gastrointestinal vascular lesions and identify factors associated with recovery among patients with iron deficiency anemia and severe aortic stenosis.Design, Setting, and ParticipantsIn this prospective, single-center cohort study, patients with iron deficiency anemia on the TAVI waiting list from September 2020 to February 2022 were assessed by capsule endoscopy. Those with vascular lesions were reassessed 6 months after TAVI. Endoscopic images were anonymized and evaluated by 2 independent researchers. Data were analyzed from September 2022 to August 2024.ExposureTAVI.Main Outcomes and MeasuresThe primary outcome was the mean difference in the number of vascular lesions before vs after TAVI.ResultsA total of 24 patients (mean [SD] age, 77.4 [7.1] years; 18 [75.0%] male) underwent capsule endoscopy, and vascular lesions were present in 18 patients (75.0%). TAVI was performed in 15 of 18 patients with vascular lesions, of whom 11 agreed to a second capsule endoscopy. The mean (SD) number of vascular lesions across the gastrointestinal tract decreased from 6.4 (5.6) lesions before TAVI to 2.0 (2.1) lesions 6 months after TAVI (P = .04). The number of vascular lesions decreased in 9 of 11 patients (81.8%), including 6 patients (54.5%) who no longer had typical angiodysplasias. Resolution of angiodysplasias was less frequent in patients who had multiple valvular heart disease before TAVI (0 of 3 patients) vs those without multiple valvular heart disease (6 of 8 patients [75.0%]) and in patients with significant paravalvular leakage after TAVI (2 of 5 patients [40.0%]) vs those without significant leakage (4 of 6 patients [66.7%]).Conclusions and RelevanceIn this cohort study of 24 patients with iron deficiency anemia and severe aortic stenosis, angiodysplasias were present in 75.0% of patients. TAVI was associated with reduced size and number of angiodysplasias in these patients. These findings suggest that TAVI not only improves aortic stenosis but may also reduce gastrointestinal bleeding by resolving vascular lesions, offering a dual benefit for patients with Heyde syndrome.

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Long‐acting octreotide as rescue therapy in chronic bleeding from gastrointestinal angiodysplasia

Abstract: SUMMARY BackgroundOctreotide has shown to be effective against rebleeding from gastrointestinal angiodysplasias, but a long-term daily parenteral administration is recommended. Long-acting octreotide (LAR-OCT) could overcome such a limitation, but it has not been studied extensively.

Cited by 70 publications

References 34 publications

New insights on an old medical emergency: non-portal hypertension related upper gastrointestinal bleeding

New insights on an old medical emergency: non-portal hypertension related upper gastrointestinal bleeding

Pharmacological Therapy for Recurrent Obscure Gastrointestinal Bleeding

Gastrointestinal Angiodysplasia Resolution After Transcatheter Aortic Valve Implantation

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