title: Long-term efficacy of endoscopic coagulation for different types of gastric vascular ectasia.
abstract: OBJECTIVE
  To examine the long-term therapeutic efficacies of endoscopic cauterization for gastric vascular ectasia, according to the type of lesion.
  
  
  METHODS
  Thirty-eight patients with hemorrhagic gastric vascular ectasia (VE) were treated by endoscopic cauterization: 13 by heater probe coagulationand 25 by argon plasma coagulation. Depending on the number of lesions, 14 and 24 patients were classified into localized VE (≤ 10; LVE) and extensive VE (> 10; EVE), respectively. The patients were followed-up by repeated endoscopic examinations after the therapy, and the incidences of VE recurrence and re-bleeding from the lesions were evaluated.
  
  
  RESULTS
  Although the VE lesions disappeared initially in all the patients after the therapy, the recurrence of VE developed in 25 patients (66%) over a mid-term observation period of 32 mo, and re-bleeding occurred in 15 patients (39%). The recurrence of VE was found in all patients with EVE, with re-bleeding occurring in 14 patients (58%). In contrast, only 1 patient (7%) with LVE showed recurrence of the lesions and complicating hemorrhage. Both the cumulative recurrence-free rates and cumulative re-bleeding-free rates were significantly lower in the EVE group than in the LVE group (P < 0.001 and P < 0.001, respectively). Moreover, the cumulative re-bleeding-free rate in the EVE group was 47.6% at 1 year and 25.4% at 2 years in patients with chronic renal failure, which were significantly lower than the rates in the patients without chronic renal failure (83.3% and 74.1%, respectively) (P < 0.05).
  
  
  CONCLUSIONS
  The recurrence of VE and re-bleeding from the lesions was more frequent in the patients with EVE, especially in those with complicating renal failure.
authors.affiliation: Department of Gastroenterology and Hepatology, Faculty of Medicine, Saitama Medical University, Saitama 350-0495, Japan. imai@saitama-med.ac.jp
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Imai
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Mizuno
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Yoshino
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Kayoko
authors.initials: K
authors.lastname: Sugawara
authors.forename: Daisuke
authors.initials: D
authors.lastname: Motoya
authors.forename: Masashi
authors.initials: M
authors.lastname: Oka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mochida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057908:Argon Plasma Coagulation; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D004564:Electrocoagulation; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D005773:Gastroscopy; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D051437:Renal Insufficiency / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Argon plasma coagulation; Gastric vascular ectasia; Heater probe coagulation; Recurrence; Renal failure