Patel Anish A, Trindade Arvind J, Diehl David L, Khara Harshit S, Lee Tai-Ping, Lee Calvin, Sethi Amrita
Columbia University Medical Center, Division of Digestive and Liver Disease, New York, NY, USA.
Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Division of Gastroenterology, Long Island Jewish Medical Center, New Hyde Park, NY, USA.
United European Gastroenterol J. 2018 Oct;6(8):1155-1160. doi: 10.1177/2050640618783537. Epub 2018 Jun 12.
Argon plasma coagulation (APC) is typically the first-line therapy for gastric antral vascular ectasia (GAVE). However, many patients are refractory to APC ablation.
We examined the safety and efficacy of nitrous oxide CryoBalloon cryotherapy ablation for GAVE refractory to APC.
This is a retrospective review of patients with refractory GAVE treated with the CryoBalloon system. Technical success was defined as successful ablation of the visualized GAVE. Clinical success was defined by transfusion independence and percentage of GAVE that was eradicated.
Twenty-three patients with GAVE were included, of whom 16 patients (70%) had two treatments with the CryoBalloon and seven patients (30%) had one treatment. Technical success was achieved in all patients. At six months, 19/23 (83%) were transfusion independent, while 20/23 (87%) had more than 75% of the GAVE eradicated. Patients were transfused an average of 1.8 units/month one year prior to cryotherapy and an average of 0.3 units/month up to six months post-cryotherapy ( < 0.001). The average increase in mean hemoglobin at six months was 2.55 g/dl. No acute or late adverse events were reported.
CryoBalloon ablation is an efficacious and safe modality for the treatment of GAVE. Prospective studies need to be conducted to determine comparative results to standard therapies.
氩等离子体凝固术（APC）通常是胃窦血管扩张症（GAVE）的一线治疗方法。然而，许多患者对APC消融治疗无效。
我们研究了一氧化二氮冷冻球囊冷冻消融术治疗对APC无效的GAVE的安全性和有效性。
这是一项对接受冷冻球囊系统治疗的难治性GAVE患者的回顾性研究。技术成功定义为可视化GAVE的成功消融。临床成功定义为无需输血以及GAVE根除的百分比。
纳入23例GAVE患者，其中16例（70%）接受了两次冷冻球囊治疗，7例（30%）接受了一次治疗。所有患者均取得技术成功。六个月时，19/23（83%）的患者无需输血，而20/23（87%）的患者GAVE根除率超过75%。患者在冷冻治疗前一年平均每月输血1.8单位，冷冻治疗后六个月内平均每月输血0.3单位（< 0.001）。六个月时平均血红蛋白平均增加2.55 g/dl。未报告急性或晚期不良事件。
冷冻球囊消融术是治疗GAVE的一种有效且安全的方法。需要进行前瞻性研究以确定与标准疗法相比的结果。
