Markos Pave, Bilic Branko, Ivekovic Hrvoje, Rustemovic Nadan
Department of Gastroenterology and Hepatology, Endoscopy Unit, University Hospital Centre Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia.
Indian J Gastroenterol. 2017 Mar;36(2):145-148. doi: 10.1007/s12664-017-0748-2. Epub 2017 Apr 3.
Gastric antral vascular ectasia (GAVE) and chronic radiation proctitis (CRP) are well-known causes of repeated gastrointestinal bleeding and iron deficiency anemia. Argon plasma coagulation (APC) is the most common endoscopic therapy used, but some patients need multiple APC sessions. Radiofrequency ablation (RFA) is recently used in GAVE and CRP treatment with promising results. In this case series, we analyzed data for 15 patients with GAVE and 5 patients with CRP that had multiple prior APC treatment. They were treated with RFA HALO 90 catheter (HALO90 Ablation Catheter System; Covidien, GI Solutions, Sunnyvale, CA) in our tertiary referral center. A total of 20 patients received 32 RFA procedures (8 in the CRP group and 24 in the GAVE group). The median number of the procedures was 2 (range 1-4). The hemoglobin levels in the GAVE group were 83 g/L pre-RFA and 98 g/L post-RFA and in the CRP group, 86 g/L pre-RFA and 103 g/L post-RFA. A total of 16/20 patients (80%) were transfusion-free after the completion of RFA treatment. Technical success of the treatment was 95% (19/20 patients). RFA can be safely and successfully used in APC refractory GAVE and CRP patients.
胃窦血管扩张症（GAVE）和慢性放射性直肠炎（CRP）是反复胃肠道出血和缺铁性贫血的常见病因。氩等离子体凝固术（APC）是最常用的内镜治疗方法，但一些患者需要多次进行APC治疗。最近，射频消融术（RFA）被用于治疗GAVE和CRP，效果良好。在本病例系列中，我们分析了15例GAVE患者和5例CRP患者的数据，这些患者之前均接受过多次APC治疗。在我们的三级转诊中心，他们接受了RFA HALO 90导管（HALO90消融导管系统；柯惠医疗，胃肠解决方案部，加利福尼亚州森尼韦尔市）治疗。共有20例患者接受了32次RFA治疗（CRP组8次，GAVE组24次）。治疗次数的中位数为2次（范围1 - 4次）。GAVE组RFA治疗前血红蛋白水平为83 g/L，治疗后为98 g/L；CRP组RFA治疗前为86 g/L，治疗后为103 g/L。RFA治疗完成后，共有16/20例患者（80%）无需输血。治疗的技术成功率为95%（19/20例患者）。RFA可安全、成功地用于APC难治性GAVE和CRP患者。
