Radiofrequency Ablation for Treatment of Refractory Gastric Antral Vascular Ectasia: A Systematic Review of the Literature

Maida, Marcello; Camilleri, S.; Manganaro, M; Garufi, Serena; Scarpulla, G.

doi:10.1155/2017/5609647

Cited by 18 publications

(14 citation statements)

References 33 publications

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“…RCT data supporting efficacy in ulcer bleeding are more limited for non-contact thermal devices such as argon plasma coagulation 28. Vascular ectasias may also be treated with thermal methods, commonly argon plasma coagulation; radiofrequency ablation is another thermal contact modality sometimes used for gastric antral vascular ectasia 81…”

Section: Endoscopic Therapymentioning

confidence: 99%

Management of acute upper gastrointestinal bleeding

Stanley

Laine

2019

BMJ

179

133

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Upper gastrointestinal bleeding (UGIB) is a common medical emergency, with a reported mortality of 2-10%. Patients identified as being at very low risk of either needing an intervention or death can be managed as outpatients. For all other patients, intravenous fluids as needed for resuscitation and red cell transfusion at a hemoglobin threshold of 70-80 g/L are recommended. After resuscitation is initiated, proton pump inhibitors (PPIs) and the prokinetic agent erythromycin may be administered, with antibiotics and vasoactive drugs recommended in patients who have cirrhosis. Endoscopy should be undertaken within 24 hours, with earlier endoscopy considered after resuscitation in patients at high risk, such as those with hemodynamic instability. Endoscopic treatment is used for variceal bleeding (for example, ligation for esophageal varices and tissue glue for gastric varices) and for high risk non-variceal bleeding (for example, injection, thermal probes, or clips for lesions with active bleeding or non-bleeding visible vessel). Patients who require endoscopic therapy for ulcer bleeding should receive high dose proton pump inhibitors after endoscopy, whereas those who have variceal bleeding should continue taking antibiotics and vasoactive drugs. Recurrent ulcer bleeding is treated with repeat endoscopic therapy, with subsequent bleeding managed by interventional radiology or surgery. Recurrent variceal bleeding is generally treated with transjugular intrahepatic portosystemic shunt. In patients who require antithrombotic agents, outcomes appear to be better when these drugs are reintroduced early.

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Section: Endoscopic Therapymentioning

confidence: 99%

Management of acute upper gastrointestinal bleeding

Stanley

Laine

2019

BMJ

179

133

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“…2.5.6. Radiofrequency Ablation (RFA) RFA has been widely applied in Barrett esophagus treatment with and without dysplasia [68]. RFA has been proposed as a good alternative for argon plasma in GAVE lesions.…”

Section: Cryotherapymentioning

confidence: 99%

New Trends and Advances in Non-Variceal Gastrointestinal Bleeding—Series II

Cañamares-Orbís

Lanas

2021

JCM

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The gastrointestinal tract is a long tubular structure wherein any point in the mucosa along its entire length could be the source of a hemorrhage. Upper (esophagel and gastroduodenal) and lower (jejunum, ileum, and colon) gastrointestinal bleeding are common. Gastroduodenal and colonic bleeding are more frequent than bleeding from the small bowel, but nowadays the entire gastrointestinal tract can be explored endoscopically and bleeding lesions can be locally treated successfully to stop or prevent further bleeding. The extensive use of antiplatelet and anticoagulants drugs in cardiovascular patients is, at least in part, the cause of the increasing number of patients suffering from gastrointestinal bleeding. Patients with these conditions are usually older and more fragile because of their comorbidities. The correct management of antithrombotic drugs in cases of gastrointestinal bleeding is essential for a successful outcome for patients. The influence of the microbiome in the pathogenesis of small bowel bleeding is an example of the new data that are emerging as potential therapeutic target for bleeding prevention. This text summarizes the latest research and advances in all forms of acute gastrointestinal bleeding (i.e., upper, small bowel and lower). Diagnosis is approached, and medical, endoscopic or antithrombotic management are discussed in the text in an accessible and comprehensible way.

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“…28 Vascular ectasias may also be treated with thermal methods, commonly argon plasma coagulation; radiofrequency ablation is another thermal contact modality sometimes used for gastric antral vascular ectasia. 81 Endoscopic injection of epinephrine should not be used as a single modality treatment. Meta-analyses have reported lower rates of further bleeding with an alternative modality compared with epinephrine alone (relative risk 0.58, 0.36 to 0.93) and with epinephrine combined with a second modality versus epinephrine alone (relative risk 0.34, 0.23 to 0.50).…”

Section: Endoscopic Therapy Non-variceal Bleedingmentioning

confidence: 99%

Management of acute upper gastrointestinal bleeding

2018

Pharmaceutical Journal

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summarizing evidence for risk assessment, resuscitation, blood transfusion, medical and endoscopic therapy, and early post-endoscopic management. We will not review interventions for long term secondary prevention of bleeding, such as testing for and treating Helicobacter pylori infection, use of non-steroidal anti-inflammatory drugs (NSAIDs), or maintenance antisecretory therapy.Upper gastrointestinal bleeding is managed by many clinicians across many specialties, including emergency room physicians, hospitalists, internists, gastroenterologists, surgeons, interventional radiologists, and hematologists.A variety of topics-including risk assessment, the threshold for blood transfusion, the timing of endoscopy, and medical and endoscopic therapies-have continued to evolve in recent years. In addition, it has become increasingly important and complex to determine the appropriate management of patients who need antithrombotic agents, with gastroenterological, cardiovascular, and hematological aspects needing to be considered.This article provides a comprehensive and evidence based summary of the assessment and management of patients with acute upper gastrointestinal bleeding, which is relevant to clinician specialists, academics, and clinical researchers. A summary of management is provided in the box.

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Radiofrequency Ablation for Treatment of Refractory Gastric Antral Vascular Ectasia: A Systematic Review of the Literature

Cited by 18 publications

References 33 publications

Management of acute upper gastrointestinal bleeding

Management of acute upper gastrointestinal bleeding

New Trends and Advances in Non-Variceal Gastrointestinal Bleeding—Series II

Management of acute upper gastrointestinal bleeding

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