Efficacy and safety of sirolimus in the treatment of gastrointestinal angiodysplasias

Figure 1 Typical endoscopic images of intestinal angiodysplasias. A: At 50 cm from the pylorus, multiple punctate erythemas are observed, some with blood seepage, classified as Yano-Yamamoto type 1a; B: At 150 cm from the pylorus in the jejunum, after removal of blood clots and irrigation, two sites of non-pulsatile active bleeding are visible, classified as type 1a; C: At 270 cm from the ileocecal valve, patchy erythema is observed without seepage, classified as type 1b; D: At 100 cm from the pylorus in the jejunum, active bleeding is evident; after irrigation, no pulsation is detected, and the base of the erythema is larger than 1 mm, classified as type 1b. Indicated by black arrows.

Figure 2 Schematic overview of the clinical management of patients with gastrointestinal angiodysplasias before and after sirolimus treatment. The timelines highlight blood transfusions, endoscopic treatments, and sirolimus administration.

Figure 3 Before and after 3 months and 6 months of sirolimus administration. A: Average bleeding episodes; B: Average hemoglobin concentration; C: The clinical effectiveness score. ^bP < 0.01. ^cP < 0.001. P were compared with pre-sirolimus. Hb: Hemoglobin.

Figure 4 Endoscopic and histopathological observations of intestinal angiodysplasias. A: Endoscopic image showing significant patchy erythema and bleeding before sirolimus treatment; B: Endoscopic image after sirolimus treatment, revealing a significant reduction in vascular lesions; C: Histopathological image of intestinal angiodysplasias. scale bar: 100 μm.

Figure 5 Sirolimus treatment for patients with gastrointestinal angiodysplasias. q.d.: Quaque die.