Argon plasma coagulation for prevention of recurrent bleeding from GI angiodysplasias.
BACKGROUND
Angiodysplasia is a frequent cause of GI bleeding. Argon plasma coagulation has been shown to arrest bleeding, but its efficacy for prevention of recurrent bleeding has not been thoroughly evaluated. This study assessed the effectiveness and the safety of argon plasma coagulation for prevention of recurrent bleeding from GI angiodysplasias.


METHODS
A total of 60 patients with GI bleeding caused by angiodysplasia were included. The endoscopic intervention was considered successful if there was no further overt bleeding and if the Hb level stabilized. Recurrent bleeding was defined as any detectable bleeding episode (hematemesis, melena, or hematochezia) or a decrease in Hb level.


RESULTS
Overt bleeding was resolved, and the Hb level stabilized without transfusion or supplemental iron therapy in 50 of the 60 patients (83%) at a median follow-up of 18 months (range 6-38 months). In the subgroup of patients with anemia, mean Hb level increased from 8.6 g/dL (range 5.1-12.2 g/dL) to 12 g/dL (range 8.0-15.2 g/dL) ( p < 0.01). The estimated probability of remaining free of recurrent bleeding at 1- and 2-year follow-up was 86%: 95% CI [73%, 93%] and 80%: 95% CI [64%, 89%], respectively. Among 72 procedures, only two were associated with a complication (2.8%).


CONCLUSIONS
Endoscopic argon plasma coagulation is both effective and safe for prevention of recurrent bleeding from GI angiodysplasia.
Olmos
Jorge Atilio
JA
Gastroenterology Service, Department of Internal Medicine, Hospital Italiano de Buenos Aires, Gascón 450, 1181 Buenos Aires, Argentina.
Marcolongo
Mariano
M
Pogorelsky
Valeria
V
Varela
Emilio
E
Dávolos
Jorge Ricardo
JR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016888:Angiodysplasia / Q000517:prevention & control / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000517:prevention & control / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000517:prevention & control / Q000601:surgery*; D006452:Hemoglobinometry; D006489:Hemostatic Techniques; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011336:Probability; D011446:Prospective Studies; D012086:Reoperation; D055502:Secondary Prevention; D016896:Treatment Outcome