CLINICAL APPROACH TO GASTRIC ANTRAL VASCULAR ECTASIA (GAVE) IN THE CZECH REPUBLIC

Aims The aim of the study was to assess real clinical approach to the patients with GAVE in the Czech Republic, identify differences in the availability of specialized therapeutic methods and estimate the number of patients refractory to endoscopic argon plasma coagulation (APC) and requiring other therapeutic methods.

Methods Web based anonymous questionnaire focused on epidemiology and typical clinical approach to diagnosis and therapy of GAVE among members of Czech Gastroenterological Society.

Results From analysis of 48 responses estimated prevalence of GAVE is 1–2 per 1 000 gastroscopies, in half of patients related to portal hypertension. In two thirds of them, endoscopic therapy is indicated with long term efficacy in about 70%. Proton pump inhibitors are extensively prescribed and endoscopic therapy with APC is commenced in patients with anemia predominantly. Other drugs or endoscopic techniques are available in 10% of hospitals only. Common technique of APC procedure includes 3–4 sessions in 4 weeks interval. In failure of initial series of APC, other type of intervention including radiofrequency ablation, band ligation or use of another drugs (e.g. thalidomide) is indicated in one third of patients only. Majority of patients are treated by multiple APC procedures for many months with limited effect only. In 2–3% of patients, surgical procedure is indicated for the failure of other therapy.

Conclusions Initiation of endoscopic therapy, therapeutic outcomes and use other methods besides APC are very variable in the Czech Republic. Up to 30 patients annually may benefit from extension of therapeutic modalities beyond APC failure.

Publication History

Article published online:
14 April 2022