Year 2024 / Volume 116 / Number 5
Letter
Hybrid-APC treatment for gastric vascular ectasia of an atypical location after failed radiofrequency ablation

289-290

DOI: 10.17235/reed.2023.9709/2023

José Manuel Palma García, Raúl Honrubia López, Cristina Fernández de Castro, Carmen Comas Redondo,

Abstract
A 76-year-old woman was being followed up for chronic anemia secondary to bleeding from vascular ectasias at the gastric antrum and the cardial and subcardial region. On several occasions the patient required fulguration of these lesions with conventional APC, which resulted in no clear improvement. Radiofrequency ablation of these lesions was then attempted using a 90-degree probe, which was successful on antral angiodysplasias but failed to remove lesions in the cardial and subcardial region since anatomy there prevented proper apposition of the probe onto the target mucosa. Given the absence of any improvement, it was decided to use fulguration for angiectasias at the cardial and subcardial level by means of Hybrid-APC, which consists of lifting the mucosa with an injection through the APC probe and then fulgurating in the pulsedAPC® mode, thus achieving a broader ablation area in a shorter time. During the subsequent review a clear reduction of vascular ectasias was observed.
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References
1. Friedel D. Potential role of new technological innovations in nonvariceal hemorrhage. World J Gastrointest Endosc. 2019 Aug 16;11(8):443-453.
2. Shah SN, Chehade NEH, Tavangar A, et al. Hybrid argon plasma coagulation in Barrett's esophagus: a systematic review and meta-analysis. Clin Endosc. 2023 Jan;56(1):38-49
3. Manner H, Neugebauer A, Scharpf M, et al. The tissue effect of argon-plasma coagulation with prior submucosal injection (Hybrid-APC) versus standard APC: A randomized ex-vivo study. United European Gastroenterol J. 2014 Oct;2(5):383-90.
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Palma García J, Honrubia López R, Fernández de Castro C, Comas Redondo C. Hybrid-APC treatment for gastric vascular ectasia of an atypical location after failed radiofrequency ablation. 9709/2023


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Publication history

Received: 07/05/2023

Accepted: 12/05/2023

Online First: 14/06/2023

Published: 09/05/2024

Article Online First time: 38 days

Article editing time: 368 days


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