title: Small Intestinal Angioectasia: Characterization, Risk Factors, and Rebleeding.
abstract: BACKGROUND
  Gastrointestinal angioectasias (AEs) represent the most common vascular malformation within the gastrointestinal tract. This study sought to characterize epidemiologic/comorbid risk factors for AEs, rebleeding, and patterns of anatomic distribution within the small intestine.
  
  
  METHODS
  This retrospective observational cohort study included 158 patients with AEs on capsule endoscopy (CE) from 2007 to 2015. Epidemiologic/comorbid data were collected and incorporated into final analysis. Each AE was categorized by location using a small bowel transit time-based quartile system. Rebleeding was evaluated following CE. Multivariate logistic regression was applied to statistically significant factors on univariate analysis to determine independent risk factors for rebleeding.
  
  
  RESULTS
  Most lesions were found in the first quartile (67.1%). Rebleeding occurred in 46 (29.7%) of the 156 patients for whom data were available. Rates of rebleeding were significantly higher among older patients (74.4 vs. 67.7 y, P=0.001), those with active bleeding on CE (41.3% vs. 16.5%, P=0.001), those with a history of aortic stenosis (21.7% vs. 9.2%, P=0.033), and those with AEs presents in quartile 3 (26.1% vs. 8.3%, P=0.003). Age, active bleeding on CE, and AE presence in quartile 3 were independently associated with rebleeding in multivariate analysis (P=0.009, 0.023, and 0.008, respectively).
  
  
  CONCLUSIONS
  These data help improve our knowledge of AEs regarding risk factors for rebleeding, and utilizes a novel small bowel transit time-based quartile localization method that may simplify future research and comparisons of anatomic distribution and behavior of small bowel AEs.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, University of Massachusetts Medical Center, Worcester, MA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kaufman
authors.forename: Gregory
authors.initials: G
authors.lastname: Leslie
authors.forename: Neil
authors.initials: N
authors.lastname: Marya
authors.forename: Samuel
authors.initials: S
authors.lastname: Han
authors.forename: William
authors.initials: W
authors.lastname: Gillespie
authors.forename: Erik
authors.initials: E
authors.lastname: Holzwanger
authors.forename: Richard
authors.initials: R
authors.lastname: Leslie
authors.forename: David
authors.initials: D
authors.lastname: Cave
mesh_terms: D000368:Aged; D001165:Arteriovenous Malformations / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D053704:Capsule Endoscopy; D015331:Cohort Studies; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D006801:Humans; D007421:Intestine, Small; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008499:Medical Records; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors