Endoscopy 2021; 53(S 01): S124
DOI: 10.1055/s-0041-1724584
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Clinical Usefulness of Combination Therapy Using Polidocanol Injection and Argon Plasma Coagulation for Gastric Antral Vascular Ectasia

H Tamari
1   Hiroshima University, Department of Endoscopy, Hiroshima, Japan
,
S Oka
2   Hiroshima University, Department of Gastroenterology and Metabolism, Hiroshima, Japan
,
S Tanaka
1   Hiroshima University, Department of Endoscopy, Hiroshima, Japan
,
N Yorita
2   Hiroshima University, Department of Gastroenterology and Metabolism, Hiroshima, Japan
,
H Tanaka
2   Hiroshima University, Department of Gastroenterology and Metabolism, Hiroshima, Japan
,
K Yamashita
1   Hiroshima University, Department of Endoscopy, Hiroshima, Japan
,
Y Ninomiya
1   Hiroshima University, Department of Endoscopy, Hiroshima, Japan
,
T Kotachi
1   Hiroshima University, Department of Endoscopy, Hiroshima, Japan
,
T Boda
1   Hiroshima University, Department of Endoscopy, Hiroshima, Japan
,
Y Kitadai
3   Prefectural University of Hiroshima, Department of Health and Science, Hiroshima, Japan
,
K Chayama
2   Hiroshima University, Department of Gastroenterology and Metabolism, Hiroshima, Japan
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Aims Gastric antral vascular ectasia (GAVE) is one of the forms in upper gastrointestinal bleeding. Various treatment options have been proposed, including endoscopic hemostasis and pharmacological therapy. In this study, we evaluated the usefulness of combination therapy using polidocanol injection (PDI) and argon plasma coagulation (APC) as a treatment for GAVE.

Methods We retrospectively analyzed the data on 15 consecutive patients with GAVE treated with PDI+APC at Hiroshima University Hospital between November 2011 and September 2019, regarding clinical characteristics, hemostatic efficacy, recurrence rate, and time to recurrence.

Results The study group included 4 males and 11 females, with a mean age of 74±8.4 years. The mean hemoglobin level at the time of GAVE diagnosis was 6.5±1.4 g/dL, with 6 patients (40 %) requiring a blood transfusion. Concomitant diseases included liver cirrhosis (7 patients, 47 %), chronic renal failure (7 patients, 47 %), and autoimmune diseases (7 patients, 47 %). The endoscopic findings revealed diffuse type of GAVE (10 patients, 67 %) and watermelon type of GAVE (5 patients, 33 %). With respect to the background mucosa of the stomach, open-type atrophy was observed in 7 patients (47 %) and close-type atrophy in 3 (20 %), with no atrophy in other 5 patients (33 %). For all patients, the treatment consisted of initial PDI (mean, 1.5±0.8 sessions) followed by additional APC (mean, 1.9±1.3 sessions); hemostasis was confirmed in all patients. Adverse events included ulcer formation in 1 patient (7 %) and a hematoma in 1 patient (7 %); healing of the mucosa was achieved in both patients with conservative treatment. The mean observation period was 54±34 months, with recurrence in 2 patients (13 %), with a mean time to recurrence of 42 months.

Conclusions Combination therapy using PDI+APC is useful and safe for the treatment of patients with GAVE.

Citation: Tamari H, Oka S, Tanaka S et al. eP85 CLINICAL USEFULNESS OF COMBINATION THERAPY USING POLIDOCANOL INJECTION AND ARGON PLASMA COAGULATION FOR GASTRIC ANTRAL VASCULAR ECTASIA. Endoscopy 2021; 53: S124.



Publication History

Article published online:
19 March 2021

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