Long-term effect of argon plasma coagulation (APC) in the treatment of gastric antral vascular ectasia (GAVE)

Abstract

Background and study aims Gastric antral vascular ectasia (GAVE) is a distinct vascular abnormality, mainly involving the gastric antrum. It is a rare but well-known cause of occult gastrointestinal bleeding. Various endoscopic treatment modalities have been tried in this condition. The aim of the study is to show the long-term effect of argon plasma coagulation (APC) on GAVE. Patients and methods Twenty-nine patients with endoscopically proved GAVE were enrolled in the study. Clinical assessment of GAVE patients, haemoglobin (Hb) level and transfused blood units were recorded after APC using 60–80-W power setting. A second session was done 1 month after the therapeutic procedure to ensure complete ablation of all lesions. Results The documented Hb levels and number of blood units transfused 3 months after APC were recorded. At endoscopy, all patients had the classic type of GAVE. The mean Hb level increased from 7.5 ± 1.7 g dl −1 before APC to 10.2 ± 0.8 g dl −1 after APC ( p value <0.001). The transfusion requirements significantly decreased to 0.2 ± 0.5 units/patient ( p value <0.001). Conclusion Endoscopic APC is a safe, effective and inexpensive modality in treating GAVE and could be an alternative to the currently available endoscopic methods.