Introduction Argon plasma coagulation (APC) is an established endoscopic therapy for various gastrointestinal disorders but with varied success in the management of Gastric Antral Vascular Ectasia (GAVE). The aim of this study was to assess the efficacy of APC in the management of patients with GAVE.
Methods Retrospective audit of upper GI endoscopies (UGIE) performed at our institution between 1 January 2007 and 31 December 2011. Data were extracted from the endoscopy reporting software (Unisoft) database using search term “argon plasma coagulation.” The case notes were reviewed for those patients undergoing APC for a diagnosis of GAVE.
Results 306 episodes of APC were noted on 127 patients. Of these 135 APC sessions were performed on 30 patients for management of GAVE. Of the 30 patients 17 (57%) were women. The median age was 68 (range 44–89) years. Co-morbidities included chronic kidney disease in 9 (30%), chronic liver disease in 7 (23%), malignancy in 4 (13%), scleroderma in 3 (10%). Seven (23%) patients were on Aspirin, 1 (3%) on Clopidogrel, 1 (3%) on Clopidogrel and Aspirin and 2 (7%) on Warfarin. The indication for index UGIE was anaemia in 23 (77%) cases, iron deficiency without anaemia in 2 (7%) and acute upper gastrointestinal bleeding in 5 (17%). APC therapy was applied at 50–65 watts. A cluster of multiple sessions of APC was treated as “one cycle” of therapy. APC was applied with success in single cycle lasting over a median period of 2 (range 0–30) months with median of 3 (range 1–24) APC sessions. Six (20%) patients required a single session of APC. The median follow-up period was 26.5 (range 1–59) months. We noted mean haemoglobin (Hb) rise of 22% and Hb normalised in 57% cases. In 3 (10%) patients symptomatic anaemia recurred and two of them required one further cycle and one required two cycles of APC therapy. There was no significant difference in the index Hb and number of APC sessions required between men and women. However, 13 out of 17 (75%) women normalised their Hb at the end of therapy while only four out of 13 (31%) of men could achieve normal Hb at the end of treatment.
Conclusion Argon plasma coagualtion appears to be an effective therapy for patients with Gastric Antral Vascular Ectasia.
Competing interests None declared.
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