title: Endoscopic argon plasma coagulation for the treatment of gastric antral vascular ectasia-related bleeding in patients with liver cirrhosis.
abstract: OBJECTIVE
  Gastric antral vascular ectasia (GAVE) is a cause of bleeding in patients with liver cirrhosis. Argon plasma coagulation (APC) is the most used endoscopic treatment for GAVE-related bleeding. Treatment failures have been described in patients with haemorrhagic diathesis; post-procedure complications include haemorrhages and septicaemia. The aim of the study was to evaluate efficacy and safety of APC treatment of GAVE-related bleeding in patients with liver cirrhosis.
  
  
  METHODS
  Patients included were suffering from GAVE-related bleeding and liver cirrhosis. APC treatment was performed until eradication. Resolution of transfusion-dependent anaemia and evaluation of complications were the primary outcomes.
  
  
  RESULTS
  20 patients (16 Child C and 4 Child B) were enrolled and prospectively followed for a mean period of 28 months. GAVE eradication was achieved in all patients after a median of 3 sessions (range 1-10). Resolution of anaemia was achieved in 18 patients. Six patients had relapse of GAVE after a mean of 7.7 months, successfully retreated by APC. Hyperplastic polyps developed in 3 patients causing active bleeding in 2 cases. Five patients had liver transplants and 1 had a relapse of GAVE after transplantation.
  
  
  CONCLUSIONS
  APC is an effective and safe endoscopic treatment for GAVE in patients with liver cirrhosis.
authors.affiliation: Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Fuccio
authors.forename: R M
authors.initials: RM
authors.lastname: Zagari
authors.forename: M
authors.initials: M
authors.lastname: Serrani
authors.forename: L H
authors.initials: LH
authors.lastname: Eusebi
authors.forename: D
authors.initials: D
authors.lastname: Grilli
authors.forename: V
authors.initials: V
authors.lastname: Cennamo
authors.forename: L
authors.initials: L
authors.lastname: Laterza
authors.forename: S
authors.initials: S
authors.lastname: Asioli
authors.forename: L
authors.initials: L
authors.lastname: Ceroni
authors.forename: F
authors.initials: F
authors.lastname: Bazzoli