Endoscopic mucosal ablation for the treatment of gastric antral vascular ectasia with the HALO90 system: a pilot study.
BACKGROUND
Gastric antral vascular ectasia (GAVE) often results in GI bleeding and chronic anemia. Treatment options are limited and include medical, endoscopic, and surgical therapies.


OBJECTIVE
To assess the utility of endoscopic mucosal ablative therapy by using the HALO(90) system for patients with GAVE and recurrent bleeding.


METHODS
Prospective open-label case series.


METHODS
Tertiary referral center.


METHODS
Six consecutive patients with GAVE, bleeding, and blood transfusion dependence.


METHODS
Comparison of preablation and postablation Hb levels and transfusion requirements. To assess the number of ablation sessions needed to stabilize the Hb level and eliminate the need for blood transfusion.


RESULTS
Six patients, (4 men, mean age 58 years, range 47-65 years) underwent endoscopic mucosal ablation of antral lesions (mean procedure time 29 minutes; mean treatments 1.7, range 1-3). The mean Hb level improved from 8.6 to 10.2 g/dl (mean 2 months after the last ablation). Five of 6 patients are no longer dependent on blood transfusions to maintain a stable Hb level.


CONCLUSIONS
This is a pilot study, with a small number of patients at a single center, with limited patient follow-up.


CONCLUSIONS
This study suggests that endoscopic mucosal ablation by using the HALO(90) system is a promising treatment option for chronic bleeding related to GAVE.
Gross
Seth Andrew
SA
Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida 32224, USA.
Al-Haddad
Mohammad
M
Gill
Kanwar R S
KR
Schore
Anthony N
AN
Wallace
Michael B
MB
D000368:Aged; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods*; D004564:Electrocoagulation / Q000295:instrumentation / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D020252:Gastric Antral Vascular Ectasia / Q000601:surgery*; D005753:Gastric Mucosa / Q000601:surgery*; D020699:Gastroscopes; D016558:Hemostasis, Endoscopic / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016896:Treatment Outcome