title: Vascular targeted photodynamic therapy for bleeding gastrointestinal mucosal vascular lesions: a preliminary study.
abstract: BACKGROUND
  Vascular-targeted photodynamic therapy (V-PDT) has shown good selectivity and efficacy in the treatment of certain types of vascular disease, including port wine stains, age-related macular degeneration, and esophageal varices. This study was conducted to test the efficacy and safety of V-PDT in the treatment of gastrointestinal (GI) bleeding caused by the abnormal dilatation of capillaries.
  
  
  METHODS
  Patients with bleeding GI mucosal vascular lesions treated with V-PDT were included in this retrospective study. The efficiency of V-PDT was analyzed by comparing the documented endoscopy results, hemoglobin levels, and transfusion requirements before and at 6 months after the last V-PDT. Side effects during and after V-PDT and follow-up results were also analyzed.
  
  
  RESULTS
  Seven patients with bleeding GI mucosal vascular lesions were treated with V-PDT. After 1-4 V-PDT sessions, all patients no longer needed transfusions to maintain a stable hemoglobin level during the follow-up period of 6 months. The mean hemoglobin level of the seven patients improved from 6.21±1.48 g/dl to 11.66±1.21 g/dl (p<0.001), and the GI bleeding and melena of all the patients disappeared. No perforations, strictures, scars, or episodes of photosensitization occurred in the seven patients, and there were no recurrences of GI bleeding during the 1-21 months of further follow-up.
  
  
  CONCLUSIONS
  This preliminary study indicated that V-PDT is a highly selective, safe, well-tolerated, and effective treatment modality for bleeding GI mucosal vascular lesions. However, prospective studies with larger sample sizes are needed to confirm this finding.
authors.affiliation: Department of Laser Medicine, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing 100853, China. qiuhxref@126.com
authors.forename: Haixia
authors.initials: H
authors.lastname: Qiu
authors.forename: Yongping
authors.initials: Y
authors.lastname: Mao
authors.forename: Ying
authors.initials: Y
authors.lastname: Gu
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Jianguo
authors.initials: J
authors.lastname: Zhu
authors.forename: Jing
authors.initials: J
authors.lastname: Zeng
mesh_terms: D000328:Adult; D000368:Aged; D016503:Drug Delivery Systems / Q000379:methods; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects*; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D006415:Hematoporphyrins / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D010865:Pilot Projects; D012189:Retrospective Studies; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D006415:Hematoporphyrins; D017319:Photosensitizing Agents; C052552:photocarcinorin