title: Long-term outcome of argon plasma ablation therapy for bleeding in 100 consecutive patients with colonic angiodysplasia.
abstract: OBJECTIVE
  Angiodysplasia is a frequent cause of colonic bleeding. Argon plasma coagulation was reported to be useful in endoscopic hemostasis. However, the long-term outcomes have been poorly evaluated. This study was designed to assess the long-term outcomes of bleeding patients with colonic angiodysplasia treated by argon plasma coagulation.
  
  
  METHODS
  A cohort of 100 patients with gastrointestinal bleeding caused by colonic angiodysplasia was studied prospectively. The endoscopic intervention was considered successful if there was no further overt bleeding and hemoglobin concentration was stabilized (primary end point). Secondary end points were the requirement of blood transfusions, the need for surgery, bleeding-related mortality, and overall mortality.
  
  
  RESULTS
  Overt bleeding resolved and hemoglobin levels were stabilized without transfusions or iron therapy in 85 of 100 patients (85 percent) after a median follow-up of 20 (range, 6-62) months. Transfusion requirements ceased in 90 percent of patients and only one required surgery. No patient died because of hemorrhage. In the subgroup of patients with anemia, mean hemoglobin levels increased from 9.3 (range, 5.5-12.2) g/dl before treatment to 12.6 (range, 7.4-16.7) g/dl after treatment (P < 0.01). The probability of remaining free of rebleeding at one and two year follow-up was 98 percent (95 percent confidence interval, 96-100) and 90 percent (95 percent confidence interval, 83-97), respectively. Among 118 procedures, only two complications were observed (1.7 percent).
  
  
  CONCLUSIONS
  Endoscopic argon plasma ablation therapy is useful in the management of bleeding from colonic angiodysplasia.
authors.affiliation: Gastroenterology Service, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Jorge Atilio
authors.initials: JA
authors.lastname: Olmos
authors.forename: Mariano
authors.initials: M
authors.lastname: Marcolongo
authors.forename: Valeria
authors.initials: V
authors.lastname: Pogorelsky
authors.forename: Leandro
authors.initials: L
authors.lastname: Herrera
authors.forename: Federico
authors.initials: F
authors.lastname: Tobal
authors.forename: Jorge Ricardo
authors.initials: JR
authors.lastname: Dávolos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016888:Angiodysplasia / Q000628:therapy*; D001128:Argon; D003108:Colonic Diseases / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D016558:Hemostasis, Endoscopic; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D019370:Observation; D011446:Prospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D001128:Argon