Endoscopic treatment of gastric antral vascular ectasia in real-life settings: argon plasma coagulation or endoscopic band ligation?

AIM Efficacy of argon plasma coagulation (APC) in gastric antral vascular ectasia (GAVE) impairs on long term and depends highly on application settings. Endoscopic band ligation (EBL) might be an alternative, but evidence is limited. This study aimed to evaluate and compare the clinical efficacy of APC and EBL in GAVE. METHODS Changes in hemoglobin and transfusion need, number of treatment sessions and hospitalizations were retrospectively assessed in 63 transfusion-dependent GAVE patients (mean age: 67.1 years, 54% female) treated with either APC or EBL (45 and 18 patients, respectively) in four tertiary endoscopic centers. RESULTS Both methods increased hemoglobin levels and decreased transfusion need substantially (2.20±0.40 g/dl and -5.62±2.30 blood units with APC, and 2.74±0.61 g/dl and -4.79±2.46 blood units with EBL), without significant difference between the methods. However, less EBL sessions were required both for cessation of transfusion need (0.9±0.1 vs. 1.69±0.31, p=0.028) and for the resolution of GAVE lesions (2.86±0.68 vs. 4.43±0.76, p=0.126). CONCLUSIONS Both APC and EBL are effective in GAVE treatment. EBL might be superior in terms of number of treatment sessions, but not the influence on hemoglobin level and transfusion need. Further prospective studies with homogenized large case number and standardized APC settings are needed. This article is protected by copyright. All rights reserved.