Rebleeding risk factors of gastrointestinal angiodysplasia after argon plasma coagulation

Aims Argon plasma coagulation (APC) is indicated as a first-line treatment for bleeding angiodysplasia. The aim of this study was to identify predictive factors of recurrent bleeding after coagulation of angiodysplasia with argon plasma. Methods It was a retrospective analysis of patients with symptomatic gastroduodenal and colonic angiodysplasia treated by APC between January 2009 and March 2020. Demographic data and endoscopic findings were collected as well as treatment details and follow-up information. Results Fifty patients were included (mean age 71.2 years). Patients were referred to endoscopy to investigate other gastrointestinal bleeding (56%) or anemia (44%). Overt bleeding consisted of hematemesis (6%), melena (52%) and hematochezia (10%). The sites involved in angiodysplatic lesions were: stomach (28%), duodenum (20%) and colon (62%), including predominantly the right colon and coecum (70%). Recurrence bleeding after APC was 38%. In univariate analysis, the predictive factors of recurrent bleeding were the low pretreatment hemoglobin level (p= 0.031) and gastric site lesions (p=0.007). In multivariate analysis, only lesions in the stomach were significantly associated with recurrence bleeding (p=0.048). Conclusions Recurrence rate is significant in particular for gastric site lesions. This could be explained by the contribution of probable synchrone lesions in the small bowel. Therefore, small bowel examination via enteroscopy or capsule endoscopy is essential in patients presenting angiodysplasia lesions. Publication History Article published online: 14 April 2023 © 2023. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany