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©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jan 16, 2018; 10(1): 30-36
Published online Jan 16, 2018. doi: 10.4253/wjge.v10.i1.30
Case series on multimodal endoscopic therapy for gastric antral vascular ectasia, a tertiary center experience
Tasnia Matin, Mohammed Naseemuddin, Mohamed Shoreibah, Peng Li, Kondal Kyanam Kabir Baig, Charles Mel Wilcox, Shajan Peter
Tasnia Matin, Internal Medicine, UAB Hospital, Birmingham, AL 35233, United States
Tasnia Matin, Division of Gastroenterology, University of Alabama School of Medicine, Birmingham, AL 35294, United States
Mohammed Naseemuddin, Department of Gastroenterology, Emory, Atlanta, GA 30322, United States
Mohamed Shoreibah, Kondal Kyanam Kabir Baig, Charles Mel Wilcox, Shajan Peter, Division of Gastroenterology, University of Alabama at Birmingham, Birmingham, AL 35233, United States
Peng Li, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 25294, United States
Author contributions: Matin T was responsible for design, data collection/analysis/interpretation and drafting article; Naseemuddin M was responsible for additional design, data collection and drafting article; Shoreibah M was responsible for critical revision of the article; Li P was responsible for statistical analysis of data; Kyanam Kabir Baig K was responsible for critical revision of the article for important intellectual content; Wilcox CM was responsible for critical revision of the article for important intellectual content; Peter S was responsible for conception and design, critical revision and final approval of article.
Institutional review board statement: IRB was approved by the UAB IRB board.
Informed consent statement: Informed consent was obtained from all patients.
Conflict-of-interest statement: No authors had conflicts of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at tasniamatin@uabmc.edu. Specific consent not obtained from participants but data is anonymized and risk of identification is low.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Tasnia Matin, MD, Division of Gastroenterology, University of Alabama School of Medicine, 1720 2
nd Avenue South, BDB 380, Birmingham, AL 35294, United States.
tasniamatin@uabmc.edu
Telephone: +1-205-9962459 Fax: +1-205-9756201
Received: October 27, 2017
Peer-review started: October 28, 2017
First decision: November 14, 2017
Revised: December 13, 2017
Accepted: December 29, 2017
Article in press: December 29, 2017
Published online: January 16, 2018
Processing time: 79 Days and 12.9 Hours
AIM
To study and describe patients who underwent treatment for gastric antral vascular ectasia (GAVE) with different endoscopic treatment modalities.
METHODS
We reviewed patients with GAVE who underwent treatment at University of Alabama at Birmingham between March 1, 2012 and December 31, 2016. Included patients had an endoscopic diagnosis of GAVE with associated upper gastrointestinal bleeding or iron deficiency anemia.
RESULTS
Seven out of 15 patients had classic watermelon description for GAVE, 1/15 with diffuse/honeycomb pattern and 6/15 with nodular GAVE per EGD description. Seven out of 15 patients required multimodal treatment. Four out of six of patients with endoscopically nodular GAVE required multimodal therapy. Overall, mean pre- and post-treatment hemoglobin (Hb) values were 8.2 ± 0.8 g/dL and 9.7 ± 1.6 g/dL, respectively (P ≤ 0.05). Mean number of packed red blood cells transfusions before and after treatment was 3.8 ± 4.3 and 1.2 ± 1.7 (P ≤ 0.05), respectively.
CONCLUSION
Patients with nodular variant GAVE required multimodal approach more frequently than non-nodular variants. Patients responded well to multimodal therapy and saw decrease in transfusion rates and increase in Hb concentrations. Our findings suggest a multimodal approach may be beneficial in nodular variant GAVE.
Core tip: Over the past several years, treatment for gastric antral vascular ectasia (GAVE) has continued to evolve and the number of available treatments has continued to increase. However, the optimal treatment of GAVE is currently unknown and there currently aren’t any studies comparing every modality. However, it is becoming apparent that patients with severe, diffuse or refractory disease require multimodal therapy. Our case series not only shows that but also that patients specifically with nodular variant GAVE require and respond well to multimodal therapy.
