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To see if either method of treatment for Watermelon Stomach shows better results
Watermelon stomach (WS) is endoscopically recognized by characteristic stripes of angioectasias involving primarily the antrum, and causes transfusion-dependent anemia in the majority of patients. Current endoscopic treatment options, including argon plasma coagulation (APC) Endoscopic cryotherapy is a novel technique that has the potential to safely and more effectively treat WS by virtue of its mechanism of injury and mode of application.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1 | Active Comparator | Cryotherapy |
|
| 2 | Active Comparator | Argon Plasma Coagulation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| cryotherapy | Procedure | The Polar Wand device (GI Supply, Wayne, PA) is FDA 510(k) approved for endoscopic tissue ablation in the GI tract. It consists of a portable cryogen-containing unit and a single-use flexible cryogen spray catheter, designed for use with CO2 that is supplied in standard 20-lb cylinders. Controlled delivery of the cryogen is achieved by a foot pedal, and the tip of the catheter is maintained at about 1 cm from the mucosa. A cryogenic spray is applied to all vascular lesions until a whitened appearance of the mucosa is achieved within 3-5 seconds. Affected areas will be 'painted' by the spray catheter starting at the pylorus and sweeping proximally. A proton pump inhibitor, at double dose, will be prescribed for 1 month after each APC or cryotherapy session to promote mucosal healing post therapy. |
| Measure | Description | Time Frame |
|---|---|---|
| the proportion of clinical responders (no overt and hematological evidence of ongoing bleeding) and non-responders | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Endoscopic response will constitute the secondary outcome | 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Louis M Wongkeesong, MD | Mayo Clinic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mayo CLinic | Rochester | Minnesota | 55905 | United States |
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| ID | Term |
|---|---|
| D020252 | Gastric Antral Vascular Ectasia |
| ID | Term |
|---|---|
| D013272 | Stomach Diseases |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
| D016888 | Angiodysplasia |
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| ID | Term |
|---|---|
| D017679 | Cryotherapy |
| D057908 | Argon Plasma Coagulation |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D004564 | Electrocoagulation |
| D002425 | Cautery |
| D006489 | Hemostatic Techniques |
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|
| Argon Plasma Coagulation | Procedure | As per current clinical standard, the APC 300 device (ERBE Inc., Marietta, GA) will be used in this study. Targeted ablation of all vascular ectasias as best possible will be performed in standard fashion using an end-firing probe at a setting of 60 W and 2 L/min argon flow rate.A proton pump inhibitor, at double dose, will be prescribed for 1 month after each APC or cryotherapy session to promote mucosal healing post therapy |
|
| D014652 |
| Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D055011 |
| Ablation Techniques |
| D013514 | Surgical Procedures, Operative |
| D006488 | Hemostasis, Surgical |