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The investigators goal is to compare the standard argon plasma coagulation (APC) treatment with endoscopic band ligation (EBL) in patients with Gastric Antral Vascular Ectasia.
Gastric antral vascular ectasia (GAVE) is a vascular structural malformation in the stomach that can lead to active or chronic intermittent gastrointestinal bleeding or chronic iron-deficiency anemia.
The current standard endoscopic treatment is with APC. There have been multiple reports and case series in the literature about successful treatment with EBL for GAVE, even in cases where APC was unsuccessful for treatment of GAVE. Our goal is to compare the standard APC treatment with EBL in patients with Gastric Antral Vascular Ectasia.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Argon Plasma Coagulation | Active Comparator | Patients with GAVE and/or chronic anemia, active GI bleeding, blood transfusion requirements |
|
| Endoscopic Band Ligation | Active Comparator | Patients with GAVE and/or chronic anemia, active GI bleeding, blood transfusion requirements |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Endoscopic Band Ligation | Device | Endoscopic band ligation device: 6 Shooter Saeed Multi-Band Ligator (Cook Medical/Endoscopy) |
|
| Measure | Description | Time Frame |
|---|---|---|
| New event of upper gastrointestinal bleeding | Number of new episodes of upper gastrointestinal bleeding characterized by melena, hematemesis or quick and significant drop in hemoglobin levels will be documented after the first session of therapy.The hemoglobin level will be recorded before the procedure and 4,8,and 12 weeks after the first endoscopic treatment for GAVE to document changes from baseline. Patients showing stabilization of hemoglobin levels (no significant drop or improvement in levels) without other signs of gastrointestinal bleeding will be considered as treatment success. | one year |
| Measure | Description | Time Frame |
|---|---|---|
| Number of sessions required for GAVE eradication | The total number of endoscopic sessions required for total disappearance of the gastric antral vascular ectasia (GAVE) | one year |
| Total procedure time |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Alberta Hospital | Edmonton | Alberta | T6G2X8 | Canada | ||
| University of Alberta Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25650636 | Result | Zepeda-Gomez S, Sultanian R, Teshima C, Sandha G, Van Zanten S, Montano-Loza AJ. Gastric antral vascular ectasia: a prospective study of treatment with endoscopic band ligation. Endoscopy. 2015 Jun;47(6):538-40. doi: 10.1055/s-0034-1391395. Epub 2015 Feb 4. |
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| Argon plasma Coagulation (APC) for GAVE | Device | APC treatment for gastric antral vascular ectasia (GAVE) Argon plasma coagulation device: ERBE VIO 300D (Elektromedizin GmBH) |
|
The investigators will document the total endoscopy time required for each procedure to compare between the two devices
| one year |
| Blood transfusion requirements | The number of blood transfusions will be documented for each patient before and after the endoscopic treatment | one year |
| Iron studies | Iron levels changes in blood serum will be monitored throughout the study. | one year |
| Ferritin | Changes in ferritin levels will be monitored during the study | one year |
| Edmonton |
| Alberta |
| Canada |
| ID | Term |
|---|---|
| D020252 | Gastric Antral Vascular Ectasia |
| ID | Term |
|---|---|
| D013272 | Stomach Diseases |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
| D016888 | Angiodysplasia |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D057908 | Argon Plasma Coagulation |
| ID | Term |
|---|---|
| D004564 | Electrocoagulation |
| D002425 | Cautery |
| D013812 | Therapeutics |
| D006489 | Hemostatic Techniques |
| D055011 | Ablation Techniques |
| D013514 | Surgical Procedures, Operative |
| D006488 | Hemostasis, Surgical |
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