title: Radiofrequency ablation for treatment of refractory gastric antral vascular ectasia (with video).
abstract: OBJECTIVE
  Gastric antral vascular ectasia (GAVE) is a known cause of gastrointestinal bleeding and chronic iron deficiency anemia. Endoscopic therapy with argon plasma coagulation (APC) is widely used for treatment of GAVE, but most patients continue to require repeated blood transfusions and multiple endoscopic procedures (refractory GAVE). We describe our initial experience regarding safety and efficacy of radiofrequency ablation (RFA) therapy in treating patients with refractory GAVE.
  
  
  METHODS
  We prospectively enrolled seven patients with refractory GAVE who had multiple prior treatments with APC. These patients were treated with RFA (HALO90 ULTRA Ablation Catheter System; Covidien, GI Solutions, Sunnyvale, CA) at Ertan Digestive Disease Center at our tertiary University Hospital.
  
  
  RESULTS
  Seven patients underwent a total of 12 RFA procedures for treatment of refractory GAVE. The median number of RFA procedures was 2 (Range, 1 - 3). Average pre- and post-procedural hemoglobin were 9.3 g/dL and 10.16 g/dL, respectively. Five of seven patients (71 %) were transfusion-free after the RFA treatments while two patients continued to require blood transfusions. There were no complications in this series.
  
  
  CONCLUSIONS
  RFA can be an effective alternative to APC for treatment of GAVE refractory to previous endoscopic therapy. Additional studies are needed to identify which subset of patients will benefit the most with RFA treatment.
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, United States.
authors.forename: Tanima
authors.initials: T
authors.lastname: Jana
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, United States ; Division of Gastroenterology & Hepatology, Stanford University School of Medicine, Stanford, California, United States.
authors.forename: Nirav
authors.initials: N
authors.lastname: Thosani
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, United States ; Ertan Digestive Disease Center, Memorial Hermann Hospital, Houston, Texas, United States.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Fallon
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, United States ; Ertan Digestive Disease Center, Memorial Hermann Hospital, Houston, Texas, United States.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Dupont
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, United States ; Ertan Digestive Disease Center, Memorial Hermann Hospital, Houston, Texas, United States.
authors.forename: Atilla
authors.initials: A
authors.lastname: Ertan