Medical and Endoscopic Therapies for Angiodysplasia and Gastric Antral Vascular Ectasia: A Systematic Review

Swanson, Eric J.; Mahgoub, Amar; MacDonald, Roderick; Shaukat, Aasma

doi:10.1016/j.cgh.2013.08.038

Cited by 74 publications

(67 citation statements)

References 88 publications

(117 reference statements)

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“…Multiple endoscopic therapies, including Nd:YAG laser therapy, heater probe, monopolar therapy, and argon plasma coagulation (APC), have been reported for the ablation of GAVE [3]. However, the complication rates for these modalities are high (20 % -33 %), and rates of failed therapy of up to 14 % have been reported [4]. Endoscopic band ligation (EBL) has been reported as an alternative effective endoscopic therapy, and the rate of complications is low in comparison with those reported for APC in retrospective studies [5 -7].…”

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confidence: 98%

Gastric antral vascular ectasia: a prospective study of treatment with endoscopic band ligation

et al. 2015

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Gastric antral vascular ectasia (GAVE) is characterized by red, angiomatous lesions in the antrum organized either in stripes or in a diffuse pattern that can be associated with upper gastrointestinal bleeding. Endoscopic band ligation (EBL) has been reported as an effective alternative therapy for patients with GAVE. Consecutive patients with a diagnosis of GAVE were prospectively followed while undergoing EBL every 2 months. Hemoglobin, ferritin, and iron levels were frequently recorded, and clinical follow-up was performed. A total of 21 patients with GAVE were enrolled, and 17 of these patients (81 %) had associated co-morbidities, most frequently cirrhosis and chronic renal failure. A clinical response was achieved in 19 patients (91 %). A significant improvement in the mean hemoglobin level was noted after EBL (P < 0.001), and a significant decrease in blood transfusion requirements per month (P = 0.001). No major complications were observed during the study period. The mean follow-up was 10 months. EBL is an effective and safe treatment for GAVE. Randomized, controlled trials comparing EBL with other endoscopic therapies are warranted.

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confidence: 98%

Gastric antral vascular ectasia: a prospective study of treatment with endoscopic band ligation

et al. 2015

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“…[6][7][8] A recent systematic review found only low-quality evidence to support treatment of angioectasia bleeding with thalidomide and insufficient evidence to support the use of octreotide. 9 Thus, endoscopic treatment remains a mainstay of therapy in these patients, despite limited data on efficacy of endoscopy for treating angioectasia. On the basis of our experience with capsule endoscopy studies and treating obscure GI bleeding endoscopically with esophagogastroduodenoscopy (EGD), push enteroscopy (PE), and double-balloon enteroscopy (DBE) we hypothesized that most angioectasias are located within the proximal small bowel within reach of PE.…”

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Small Intestinal Angioectasias Are Not Randomly Distributed in the Small Bowel and Most May Be Reached by Push Enteroscopy

Plotkin

Imaeda

2016

Journal of Clinical Gastroenterology

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“…Appropriate testing and eradication of H. pylori is indicated if present, and treatment with PPIs is the mainstay of therapy. Gastric antral vascular ectasias (GAVE) can lead to chronic GI bleeding and is managed with argon plasma coagulation or other ablative techniques [78]. Gastroparesis also occurs with symptoms of early satiety, nausea/vomiting, and increased GERD symptoms.…”

Section: Gastrointestinal Manifestationsmentioning

confidence: 98%

Update on Systemic Sclerosis

McCray

Mayes

2015

Curr Allergy Asthma Rep

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Systemic sclerosis (SSc) is a rare autoimmune disease characterized by autoantibody production, small-vessel vasculopathy, and skin and other organ fibrosis. The disease is clinically heterogeneous with most patients having some degree of skin sclerosis with varying organ system involvement. Early disease can be difficult to diagnose, especially with minimal skin sclerosis and absence of anti-nuclear antibody (ANA) positivity; however, studies have demonstrated early diagnosis is important as early treatment could potentially lead to better outcomes. New classification criteria have recently been published that have higher sensitivity for detecting early disease thus allowing for a broader spectrum of patients to be represented in clinical trials. Treatment guidelines have been published based on a limited number of randomized-controlled clinical trials; however, there are ongoing phase II and III clinical trials with novel agents that are promising and will change the treatment landscape over the next decade.

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Medical and Endoscopic Therapies for Angiodysplasia and Gastric Antral Vascular Ectasia: A Systematic Review

Cited by 74 publications

References 88 publications

Gastric antral vascular ectasia: a prospective study of treatment with endoscopic band ligation

Gastric antral vascular ectasia: a prospective study of treatment with endoscopic band ligation

Small Intestinal Angioectasias Are Not Randomly Distributed in the Small Bowel and Most May Be Reached by Push Enteroscopy

Update on Systemic Sclerosis

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