Radiofrequency Ablation for Treatment of Refractory Gastric Antral Vascular Ectasia: A Systematic Review of the Literature

Background and Study Aims. GAVE is an uncommon cause of upper nonvariceal bleeding and often manifests itself as occult bleeding with chronic anemia. To date, the standard of care for GAVE is endoscopic treatment with thermoablative techniques. Despite good technical results, approximately two third...

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Main Authors: M. Maida, S. Camilleri, M. Manganaro, S. Garufi, G. Scarpulla
Format: Article
Language:English
Published: Hindawi Limited 2017-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2017/5609647
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spelling doaj-90e1d6932b4d446e9398428c88a763222020-11-24T20:55:11ZengHindawi LimitedGastroenterology Research and Practice1687-61211687-630X2017-01-01201710.1155/2017/56096475609647Radiofrequency Ablation for Treatment of Refractory Gastric Antral Vascular Ectasia: A Systematic Review of the LiteratureM. Maida0S. Camilleri1M. Manganaro2S. Garufi3G. Scarpulla4Section of Gastroenterology, S. Elia-M. Raimondi Hospital, Caltanissetta, ItalySection of Gastroenterology, S. Elia-M. Raimondi Hospital, Caltanissetta, ItalySection of Gastroenterology, S. Elia-M. Raimondi Hospital, Caltanissetta, ItalySection of Gastroenterology, S. Elia-M. Raimondi Hospital, Caltanissetta, ItalySection of Gastroenterology, S. Elia-M. Raimondi Hospital, Caltanissetta, ItalyBackground and Study Aims. GAVE is an uncommon cause of upper nonvariceal bleeding and often manifests itself as occult bleeding with chronic anemia. To date, the standard of care for GAVE is endoscopic treatment with thermoablative techniques. Despite good technical results, approximately two thirds of patients remain dependent on transfusions after the therapy. One of the emerging and more promising endoscopic treatments for GAVE is radiofrequency ablation (RFA). The aim of this study is to perform a systematic review of literature in order to assess current evidence supporting the effectiveness of this technique for treatment of refractory GAVE. Materials and Methods. Through electronic search, we identified 14 records, and after removal of duplicates and irrelevant studies, we selected 10 studies on radiofrequency ablation of GAVE: 4 prospective open-label single-center studies, 1 retrospective multicentric study, and 5 case reports. Results. Among all 72 treated patients reported in literature, 74.3% achieved a clinical response, while nonfatal AEs have been reported in 4.2% of cases. Conclusions. Despite some qualitative limitations, all literature data support effectiveness of RFA for treatment of refractory GAVE. In the future, large prospective controlled trials with adequate follow-up are needed to better assess the effectiveness and safety of this procedure.http://dx.doi.org/10.1155/2017/5609647
collection DOAJ
language English
format Article
sources DOAJ
author M. Maida
S. Camilleri
M. Manganaro
S. Garufi
G. Scarpulla
spellingShingle M. Maida
S. Camilleri
M. Manganaro
S. Garufi
G. Scarpulla
Radiofrequency Ablation for Treatment of Refractory Gastric Antral Vascular Ectasia: A Systematic Review of the Literature
Gastroenterology Research and Practice
author_facet M. Maida
S. Camilleri
M. Manganaro
S. Garufi
G. Scarpulla
author_sort M. Maida
title Radiofrequency Ablation for Treatment of Refractory Gastric Antral Vascular Ectasia: A Systematic Review of the Literature
title_short Radiofrequency Ablation for Treatment of Refractory Gastric Antral Vascular Ectasia: A Systematic Review of the Literature
title_full Radiofrequency Ablation for Treatment of Refractory Gastric Antral Vascular Ectasia: A Systematic Review of the Literature
title_fullStr Radiofrequency Ablation for Treatment of Refractory Gastric Antral Vascular Ectasia: A Systematic Review of the Literature
title_full_unstemmed Radiofrequency Ablation for Treatment of Refractory Gastric Antral Vascular Ectasia: A Systematic Review of the Literature
title_sort radiofrequency ablation for treatment of refractory gastric antral vascular ectasia: a systematic review of the literature
publisher Hindawi Limited
series Gastroenterology Research and Practice
issn 1687-6121
1687-630X
publishDate 2017-01-01
description Background and Study Aims. GAVE is an uncommon cause of upper nonvariceal bleeding and often manifests itself as occult bleeding with chronic anemia. To date, the standard of care for GAVE is endoscopic treatment with thermoablative techniques. Despite good technical results, approximately two thirds of patients remain dependent on transfusions after the therapy. One of the emerging and more promising endoscopic treatments for GAVE is radiofrequency ablation (RFA). The aim of this study is to perform a systematic review of literature in order to assess current evidence supporting the effectiveness of this technique for treatment of refractory GAVE. Materials and Methods. Through electronic search, we identified 14 records, and after removal of duplicates and irrelevant studies, we selected 10 studies on radiofrequency ablation of GAVE: 4 prospective open-label single-center studies, 1 retrospective multicentric study, and 5 case reports. Results. Among all 72 treated patients reported in literature, 74.3% achieved a clinical response, while nonfatal AEs have been reported in 4.2% of cases. Conclusions. Despite some qualitative limitations, all literature data support effectiveness of RFA for treatment of refractory GAVE. In the future, large prospective controlled trials with adequate follow-up are needed to better assess the effectiveness and safety of this procedure.
url http://dx.doi.org/10.1155/2017/5609647
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