Treatment of Gastric Antral Vascular Ectasia

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Gastric antral vascular ectasia (GAVE) is typically treated by endoscopic thermal therapies (“watermelon stomach”). Endoscopic band ligation (EBL) had been reported with encouraging results and a comprehensive search of several databases was conducted (inception to May 2021), to identify studies reporting the use of EBL in treatment of GAVE. 

A random-effects model was used to calculate the pooled rates, I² values and 95% prediction intervals were calculated to assess the heterogeneity.

Ten studies (194 patients), were included in the final analysis. The pooled rate of treatment responders with EBL in GAVE was 81% and GAVE recurrence was 15.4%. The pooled mean number of treatment sessions required was 2.4 and the number of bands used to achieve eradication per patient was 15.1. The pooled mean difference of pre- to post-treatment hemoglobin was 1.5, pre- to post-treatment units of packed red cells transfused was 1.1, and pre- to post-treatment hospital length of stay was 0.5 days. The pooled rate of overall adverse effects was 15.9%. 

It was concluded that EBL demonstrated excellent clinical outcomes in the treatment of GAVE with minimal adverse events. Multicenter randomized control trials comparing EBL and other modalities as initial therapy are warranted.

Mohan, B., Toy, G., Kassab, L., et al. “Endoscopic Band Ligation in the Treatment of Gastric Antral Vascular Ectasia:  A Systematic Review and Meta-Analysis.” Gastrointestinal Endoscopy, 2021; Vol. 94, pp. 1021-1029.

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