Clinical journal of gastroenterology · 2026
Combination sclerotherapy and band ligation for refractory transfusion-dependent nodular gastric antral vascular ectasia (GAVE): inducing submucosal scarring.
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Magahis Patrick T, Wang Thomas J, Stein Daniel J, Viveiros Kathleen, Zucker Steven D, Ryou Marvin
Аннотация
BACKGROUND: Nodular GAVE is a rare variant more common in cirrhosis that often does not respond to conventional endoscopic therapies. We present a case series of patients with cirrhosis and transfusion-dependent refractory nodular GAVE managed with serial combination sclerotherapy with sodium tetradecyl sulfate (STS) and band ligation.
METHODS: We report baseline characteristics and transfusion-related outcomes for 4 consecutive patients who underwent combination therapy.
RESULTS: STS was administered every 1 to 2 months, with the total number of sessions ranging from 5 to 8 over a median 12.3 months. One moderate adverse event, a large gastric ulcer that ultimately fully healed, occurred. At a median follow-up of 40.4 months, the frequency of transfusions had declined from 1.0 to 2.5 per month to 0 to 0.2 per month. The mean hemoglobin levels increased from 7.7 to 10.9 g/dL.
CONCLUSIONS: Combination sclerotherapy and band ligation resulted in a durable reduction in transfusion requirements and substantially increased hemoglobin for patients with cirrhosis and refractory nodular GAVE. It is postulated that STS injection may limit neovascularization driving nodular GAVE recurrence.
METHODS: We report baseline characteristics and transfusion-related outcomes for 4 consecutive patients who underwent combination therapy.
RESULTS: STS was administered every 1 to 2 months, with the total number of sessions ranging from 5 to 8 over a median 12.3 months. One moderate adverse event, a large gastric ulcer that ultimately fully healed, occurred. At a median follow-up of 40.4 months, the frequency of transfusions had declined from 1.0 to 2.5 per month to 0 to 0.2 per month. The mean hemoglobin levels increased from 7.7 to 10.9 g/dL.
CONCLUSIONS: Combination sclerotherapy and band ligation resulted in a durable reduction in transfusion requirements and substantially increased hemoglobin for patients with cirrhosis and refractory nodular GAVE. It is postulated that STS injection may limit neovascularization driving nodular GAVE recurrence.