- Email: [email protected]
Tu1736 The Cost-Effectiveness of HemosprayTMin Patients With Non Variceal Upper Gastrointestinal Bleeding
Abstracts
Tu1735 Double Endoscopic Self-Expanding Metal Stent Placement for the Treatment of Malignant Duodenal and Biliary Obstruction: a Large Series of Patients From a Referral Center for Palliative Care Roberto Di Mitri*, Filippo Mocciaro, Giulia Maria Pecoraro Gastroenterology and Endoscopy Unit, ARNAS Civico-Di CristinaBenfratelli Hospital, Palermo, Italy
Fig 2. Supervisor prompts for AEF-A and AEF-B
Introduction: Patients with malignant gastroduodenal obstructions often have coexistent biliary obstructions and require subsequent simultaneous endoscopic treatment. The use of self-expandable metal stents (SEMS) has been shown to be an effective palliative treatment in patients with unresectable malignant gastroduodenal and biliary obstructions. Aims and Methods: The aims are to report the efficacy and safety of double SEMS placement in patients with malignant inoperable gastroduodenal and biliary obstruction. From March 2007 to October 2014 we collected data on all patients treated with double SEMS placement (Wallflex Enteral and Biliary by Boston Scientific, Niti-S Biliary by Taewoong). SEMS were placed under fluoroscopic and endoscopic guidance. First the scope was allowed to reach the duodenal stricture, then a guidewire equipped with an imaging catheter was passed through the stricture allowing the deployment of the duodenal SEMS. The duodenoscope was passed through the duodenal stent for accessing the papilla through the mesh of the SEMS. After common bile duct cannulation and cholangiography a guidewire was placed across the papilla. A balloon dilation to enlarge the spacing of the tight mesh of the duodenal stent was performed allowing the placement of the biliary SEMS. If possible balloon dilation of the duodenal stricture was performed allowing the deployment of the biliary SEMS before duodenal SEMS placement. Results: 35 patients (23 male [66%]; mean age 72.410.1 year) were treated: 28 had a pancreatic head cancer (80%), 3 an antro-bulbar cancer (8.5%), 3 a duodenal obstruction due to colon cancer (8.5%), 1 a cholangiocarcinoma (3%). The mean bilirubin level and the median gastric outlet obstruction scoring system score (GOOSS; [0Zno oral intake; 1Zliquid diet; 2Zsoft solid diet; 3Zlow residue or normal diet]) were 17.13.9 mg/dL and 1 (range 0-3) respectively. Technical success was achieved in all patients with significant reduction in bilirubin levels (7.12.8 mg/dL) and a satisfactory oral feeding at discharge (GOOSS score 2 [range 2-3]). No complication related to the SEMS placement were recorded. Biliary stent occlusion occurred in 2 patients (6%) after 3 and 10 months. In 1 patient (3%) migration of the biliary stent was recorded after 5 months. The median survival time was 6 months (range 3-8) due to the natural course of underlying malignancy. Conclusions: Endoscopic management of malignant gastroduodenal and biliary obstructions with double SEMS placement is the treatment of choice in advanced unresectable gastroduodenal neoplasm. It is a safe procedure and it enhances patients’ quality of life. In advanced diseases or in frail patients palliative surgery should be considered only in case of endoscopic failure.
Tu1736 The Cost-Effectiveness of HemosprayTM in Patients With Non Variceal Upper Gastrointestinal Bleeding Alan N. Barkun*, Viviane Adam, Yen-I. Chen, Yidan Lu, Myriam Martel Gastroenterology, McGill University, The Montreal General Hospital, GI Division, Montreal, QC, Canada Tu1734 Endoscopic Resection of Esophageal Neoplasia: Comparison of Endoscopic Submucosal Dissection (ESD) With Endoscopic Mucosal Resection (EMR) in Our Institution Harutaka Kambayashi*, Makoto Nishimura, Miho Matsukawa, Yasuko Ushio, Mina Sasaki, Satoko Uegaki, Kenichirou Nakajima Gastroenterology, Tokyo Metroporitan Geriatric Hospital, Tokyo, Japan Background/Aims: Endoscopic submucosal dissection (ESD) is widely accepted as a more reliable therapeutic procedure for superficial gastrointestinal tract neoplasms compared with endoscopic mucosal resection (EMR). However, ESD for esophageal neoplasms is still associated with a high complication rate compared with EMR. For elderly patients in particular, only a few reports have evaluated the feasibility and safety of esophageal ESD. In this study, we compared consecutive elderly patients undergoing esophageal ESD with those undergoing esophageal EMR to evaluate the efficiency and complications of ESD. Methods: From April 2005 to April 2014, we performed EMR or ESD for esophageal neoplasms in 97 patients. Of the 97 patients, 74 (76.2%) underwent ESD and 21 (21.6%) underwent EMR; the endoscopic procedure failed in two patients because of the large tumor size. Results: The mean patient age was 70.1 years in the ESD group and 66.0 years in the EMR group (p Z 0.114). The resected specimen size was 29.6 mm in the ESD group and 21.5 mm in the EMR group (p Z 0.003). The en bloc resection rate was 98.6% (75/76) in the ESD group and 61.9% (13/21) in the EMR group (p Z 0.002). Although intraprocedural complications such as oxygen desaturation and hypotension occurred in the ESD group (6.21%; 7/76), there were no life-threatening complications. On the other hand, no complications were observed in the EMR group (0%; 0/21) (p Z 0.01). Conclusions: The technical problems associated with ESD are now being resolved with improvements in needles and electric cautery devices. ESD for esophageal lesions is expected to achieve good outcomes without serious side effects.
AB576 GASTROINTESTINAL ENDOSCOPY Volume 81, No. 5S : 2015
Introduction: HemosprayTM (TC-325) is an endoscopic hemostatic powder that achieves hemostasis through adherence to actively bleeding biological surfaces. Aims & Methods: We compared the cost-effectiveness of traditional endoscopic hemostatic therapies (any approach except for epinephine injection alone) and HemosprayTM in different combinations. A decision tree of patients with active Non Variceal Upper Gastrointestinal Bleeding (NVUGIB) assessed four possible treatment strategies: traditional therapy alone (T), HemosprayTM alone (H), traditional therapy completed by HemosprayTM if needed (T+H), or HemosprayTM completed by traditional therapy if needed (H+T). Using probabilities mainly from the literature, effectiveness was the likelihood of avoiding rebleeding over a 30-day time horizon. Costs in 2014US$ were based on the US National Inpatient Sample for relevant diagnoses. Physician and procedure fees were obtained from the American Medical Association and recent publications. A third-party payer perspective was adopted. Sensitivity and planned subgroup analyses were performed. Results: For all patients, T+H is more efficacious and less expensive than all other approaches, with 97% of patients eventually avoiding rebleeding at an average cost per patient of US$9,150. The second most cost-effective approach is H+T, being 5.57% less effective and costing on average US$635 more per patient. Sensitivity analyses show that T+H followed by a strategy of H+T remain more cost-effective than H or T alone when varying all probability assumptions across plausible, a priori determined ranges. Variations in physician and procedural fees and in the price of HemosprayTM do not change the final selection of preferred strategy. Varying four assumptions of diseasespecific lengths of stay make T less costly than T+H (with T+H still more effective). Subgroup analyses showed that for patients with non-ulcer lesions at low risk of delayed rebleeding, the HemosprayTM-first approach (H+T) was most effective at low incremental cost ($341 per patient) compared to T+H; the T+H strategy was most effective with varying costs differences relative to the different strategies for all other subgroups. It is more cost-effective to deliver T+H or H+T at the same endoscopy session than at a second-look endoscopy. A strategy of H alone appears ineffective in peptic ulcer bleeding. Conclusion: This cost-effectiveness analysis
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Abstracts
Strategy for all patients
Cost
Incremental Cost Effectiveness
T+H
9,150
0
T H+T H
9,296 9,786 11,123
145 635 1,973
Incremental Effectiveness
Incremental CostEffectiveness Ratio
Cost-Effectiveness Ratio
Cost-effectiveness characterization
0.9705
0
0
9,429
0.8137 0.9148 0.5453
-0.1568 -0.0557 -0.4252
-927 -11,413 -4,640
11,424 10,697 20,399
Reference strategy dominated dominated dominated
shows that HemosprayTM improves the effectiveness of traditional hemostasis, while being less costly in most patient populations presenting with NVUGIB; a HemosprayTM-first approach may be the most cost-effective for non-ulcer bleeding lesions at low risk of delayed hemorrhage. High-quality data are needed to validate these conclusions.
Methods: Consecutive patients with upper GI bleeding, undergoing RFA were retrospectively reviewed for hemoglobin and transfusion requirements 6 months prior to and after RFA. Additional outcomes included complications of RFA and number of sessions required to attain bleeding control. All data was summarized as median and interquartile ranges. Pre and post RFA periods were compared using sign rank test. All p values were two sided and considered significant when p!0.05. Results: 7 patients (5 men and 2 women), median age of 61 years (54-70 years), underwent 11 RFA sessions using channel RFA endoscopic catheter for treatment of UGIB during the study period. Indications for RFA included GAVE in 6 (86%), and AVM in 1(14%) patient. Of the 7 patients, 3 had received prior treatment with multiple APC sessions. In addition 1 patient had undergone both APC and RFA (x 1 session with HALO-90) in the past. Over a median follow-up period of 5 months, hemoglobin increased significantly in all the patients after RFA from 6.9 (6.5 - 8.1) gram/dl to 9 (8.7 - 11.5) gram/dl, (pZ0.027). A declining trend in transfusion requirement was observed from median 5 (0-28) transfusions in pre-RFA period to a median 0 (0 - 2) transfusions in post RFA period till now (pZ0.05). Two patients did not require any transfusion over 2 & 6 months of follow-up. No complications were reported in any of the sessions. Table 1 summarizes the patient demographics, prior treatment details, RFA sessions and outcomes of RFA treatment. Conclusions: RFA with “Channel RFA endoscopic catheter” is a safe and efficacious modality for management of upper GI bleed secondary to GAVE and AVM. It provides significant improvement in hemoglobin levels and decreases the requirement of blood transfusion. Future studies with longer follow-up are required to assess the long-term efficacy and safety.
Tu1737 Efficacy and Safety of Through the Scope “Channel RFA Endoscopic Catheter” in the Management of Upper GI Bleed. Ayush Arora, Sachin Batra, Moises I. Nevah, Atilla Ertan, Sushovan Guha, Andrew W. Dupont, Michael B. Fallon, Nirav Thosani* Gastroenterology, Hepatology and Nutrition, The University of Texas Health Science Center at Houston, Houston, TX Background: Gastric antral vascular ectasia (GAVE) and Arteriovenous Malformations (AVM) account for more than 4% cases of non variceal upper GI bleed (UGIB). Amongst endoscopic therapies, Argon plasma coagulation (APC) has been traditionally used for management of these conditions. Radiofrequency ablation (RFA) has been recently used in treatment of GAVE in few small studies. The safety and efficacy of Through the Scope “Channel RFA Endoscopic Catheter” (Covidien TTS1100) has not been previously studied. Aim: We evaluated the efficacy and safety of Channel RFA Endoscopic Catheter in management of UGIB due to GAVE and AVM.
Table 1. Outcomes of RFA with through the scope “Channerl RFA Endoscopic Catheter”
Age Sex Indication 70
m
GAVE
54
m
GAVE
61
f
GAVE
62
f
GAVE
56
m
GAVE
61
m
GAVE
64
m
AVM
Comorbidities HTN, GERD, h/o seizures, syncope, delirium, Diastolic HF Hepatic encephalopathy, POPH, Cirrhosis, Thrombocytopenia, Colon polyps, nonbleeding Esophageal varices Hepatitis C, Cirrhosis, Hepatic encephalopathy, CHF, DM, COPD, Hypothyroid, Hypertension COPD, CHF, HTN, Hypothyroidism, ESRD, Pulmonary Fibrosis, Adrenal Suppression Hepatitis C cirrhosis, varices, hepatic encephalopathy and HCC, COPD, Gastro paresis, Hemorrhoids Cirrhosis, CAD, ESRD, DM, HTN, Hypothyroidism, Hearing impairment Hepatitis C, Cirrhosis, Portal Hypertension, DM, p/h/o CHF
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Prior endoscopic therapy
Prior APC (n)
Prior RFA (n)
RFA Sessions (n)
Lesion SIte
Pre RFA Hgb
Post RFA Hgb
f/u Pre RFA Post RFA period Transfusion Transfusion Complications (months)
no
0
0
1
Antrum
10
un
5
0
no
4
yes
2
0
2
Antrum
6.5
8.7
15
2
no
6
yes
4
1
2
Antrum
5.8
8.6
28
2
no
5
yes
1
0
1
Antrum
11
un
0
0
no
5.5
no
0
0
1
Antrum
8.1
11.5
0
0
no
2
yes
3
0
3
Antrum
6.9
9
60
4
no
5
no
0
0
1
Fundus
13.1
13.8
0
0
no
0.5
Volume 81, No. 5S : 2015 GASTROINTESTINAL ENDOSCOPY AB577
Tu1735 Double Endoscopic Self-Expanding Metal Stent Placement for the Treatment of Malignant Duodenal and Biliary Obstruction: a Large Series of Patients From a Referral Center for Palliative Care Roberto Di Mitri*, Filippo Mocciaro, Giulia Maria Pecoraro Gastroenterology and Endoscopy Unit, ARNAS Civico-Di CristinaBenfratelli Hospital, Palermo, Italy
Fig 2. Supervisor prompts for AEF-A and AEF-B
Introduction: Patients with malignant gastroduodenal obstructions often have coexistent biliary obstructions and require subsequent simultaneous endoscopic treatment. The use of self-expandable metal stents (SEMS) has been shown to be an effective palliative treatment in patients with unresectable malignant gastroduodenal and biliary obstructions. Aims and Methods: The aims are to report the efficacy and safety of double SEMS placement in patients with malignant inoperable gastroduodenal and biliary obstruction. From March 2007 to October 2014 we collected data on all patients treated with double SEMS placement (Wallflex Enteral and Biliary by Boston Scientific, Niti-S Biliary by Taewoong). SEMS were placed under fluoroscopic and endoscopic guidance. First the scope was allowed to reach the duodenal stricture, then a guidewire equipped with an imaging catheter was passed through the stricture allowing the deployment of the duodenal SEMS. The duodenoscope was passed through the duodenal stent for accessing the papilla through the mesh of the SEMS. After common bile duct cannulation and cholangiography a guidewire was placed across the papilla. A balloon dilation to enlarge the spacing of the tight mesh of the duodenal stent was performed allowing the placement of the biliary SEMS. If possible balloon dilation of the duodenal stricture was performed allowing the deployment of the biliary SEMS before duodenal SEMS placement. Results: 35 patients (23 male [66%]; mean age 72.410.1 year) were treated: 28 had a pancreatic head cancer (80%), 3 an antro-bulbar cancer (8.5%), 3 a duodenal obstruction due to colon cancer (8.5%), 1 a cholangiocarcinoma (3%). The mean bilirubin level and the median gastric outlet obstruction scoring system score (GOOSS; [0Zno oral intake; 1Zliquid diet; 2Zsoft solid diet; 3Zlow residue or normal diet]) were 17.13.9 mg/dL and 1 (range 0-3) respectively. Technical success was achieved in all patients with significant reduction in bilirubin levels (7.12.8 mg/dL) and a satisfactory oral feeding at discharge (GOOSS score 2 [range 2-3]). No complication related to the SEMS placement were recorded. Biliary stent occlusion occurred in 2 patients (6%) after 3 and 10 months. In 1 patient (3%) migration of the biliary stent was recorded after 5 months. The median survival time was 6 months (range 3-8) due to the natural course of underlying malignancy. Conclusions: Endoscopic management of malignant gastroduodenal and biliary obstructions with double SEMS placement is the treatment of choice in advanced unresectable gastroduodenal neoplasm. It is a safe procedure and it enhances patients’ quality of life. In advanced diseases or in frail patients palliative surgery should be considered only in case of endoscopic failure.
Tu1736 The Cost-Effectiveness of HemosprayTM in Patients With Non Variceal Upper Gastrointestinal Bleeding Alan N. Barkun*, Viviane Adam, Yen-I. Chen, Yidan Lu, Myriam Martel Gastroenterology, McGill University, The Montreal General Hospital, GI Division, Montreal, QC, Canada Tu1734 Endoscopic Resection of Esophageal Neoplasia: Comparison of Endoscopic Submucosal Dissection (ESD) With Endoscopic Mucosal Resection (EMR) in Our Institution Harutaka Kambayashi*, Makoto Nishimura, Miho Matsukawa, Yasuko Ushio, Mina Sasaki, Satoko Uegaki, Kenichirou Nakajima Gastroenterology, Tokyo Metroporitan Geriatric Hospital, Tokyo, Japan Background/Aims: Endoscopic submucosal dissection (ESD) is widely accepted as a more reliable therapeutic procedure for superficial gastrointestinal tract neoplasms compared with endoscopic mucosal resection (EMR). However, ESD for esophageal neoplasms is still associated with a high complication rate compared with EMR. For elderly patients in particular, only a few reports have evaluated the feasibility and safety of esophageal ESD. In this study, we compared consecutive elderly patients undergoing esophageal ESD with those undergoing esophageal EMR to evaluate the efficiency and complications of ESD. Methods: From April 2005 to April 2014, we performed EMR or ESD for esophageal neoplasms in 97 patients. Of the 97 patients, 74 (76.2%) underwent ESD and 21 (21.6%) underwent EMR; the endoscopic procedure failed in two patients because of the large tumor size. Results: The mean patient age was 70.1 years in the ESD group and 66.0 years in the EMR group (p Z 0.114). The resected specimen size was 29.6 mm in the ESD group and 21.5 mm in the EMR group (p Z 0.003). The en bloc resection rate was 98.6% (75/76) in the ESD group and 61.9% (13/21) in the EMR group (p Z 0.002). Although intraprocedural complications such as oxygen desaturation and hypotension occurred in the ESD group (6.21%; 7/76), there were no life-threatening complications. On the other hand, no complications were observed in the EMR group (0%; 0/21) (p Z 0.01). Conclusions: The technical problems associated with ESD are now being resolved with improvements in needles and electric cautery devices. ESD for esophageal lesions is expected to achieve good outcomes without serious side effects.
AB576 GASTROINTESTINAL ENDOSCOPY Volume 81, No. 5S : 2015
Introduction: HemosprayTM (TC-325) is an endoscopic hemostatic powder that achieves hemostasis through adherence to actively bleeding biological surfaces. Aims & Methods: We compared the cost-effectiveness of traditional endoscopic hemostatic therapies (any approach except for epinephine injection alone) and HemosprayTM in different combinations. A decision tree of patients with active Non Variceal Upper Gastrointestinal Bleeding (NVUGIB) assessed four possible treatment strategies: traditional therapy alone (T), HemosprayTM alone (H), traditional therapy completed by HemosprayTM if needed (T+H), or HemosprayTM completed by traditional therapy if needed (H+T). Using probabilities mainly from the literature, effectiveness was the likelihood of avoiding rebleeding over a 30-day time horizon. Costs in 2014US$ were based on the US National Inpatient Sample for relevant diagnoses. Physician and procedure fees were obtained from the American Medical Association and recent publications. A third-party payer perspective was adopted. Sensitivity and planned subgroup analyses were performed. Results: For all patients, T+H is more efficacious and less expensive than all other approaches, with 97% of patients eventually avoiding rebleeding at an average cost per patient of US$9,150. The second most cost-effective approach is H+T, being 5.57% less effective and costing on average US$635 more per patient. Sensitivity analyses show that T+H followed by a strategy of H+T remain more cost-effective than H or T alone when varying all probability assumptions across plausible, a priori determined ranges. Variations in physician and procedural fees and in the price of HemosprayTM do not change the final selection of preferred strategy. Varying four assumptions of diseasespecific lengths of stay make T less costly than T+H (with T+H still more effective). Subgroup analyses showed that for patients with non-ulcer lesions at low risk of delayed rebleeding, the HemosprayTM-first approach (H+T) was most effective at low incremental cost ($341 per patient) compared to T+H; the T+H strategy was most effective with varying costs differences relative to the different strategies for all other subgroups. It is more cost-effective to deliver T+H or H+T at the same endoscopy session than at a second-look endoscopy. A strategy of H alone appears ineffective in peptic ulcer bleeding. Conclusion: This cost-effectiveness analysis
www.giejournal.org
Abstracts
Strategy for all patients
Cost
Incremental Cost Effectiveness
T+H
9,150
0
T H+T H
9,296 9,786 11,123
145 635 1,973
Incremental Effectiveness
Incremental CostEffectiveness Ratio
Cost-Effectiveness Ratio
Cost-effectiveness characterization
0.9705
0
0
9,429
0.8137 0.9148 0.5453
-0.1568 -0.0557 -0.4252
-927 -11,413 -4,640
11,424 10,697 20,399
Reference strategy dominated dominated dominated
shows that HemosprayTM improves the effectiveness of traditional hemostasis, while being less costly in most patient populations presenting with NVUGIB; a HemosprayTM-first approach may be the most cost-effective for non-ulcer bleeding lesions at low risk of delayed hemorrhage. High-quality data are needed to validate these conclusions.
Methods: Consecutive patients with upper GI bleeding, undergoing RFA were retrospectively reviewed for hemoglobin and transfusion requirements 6 months prior to and after RFA. Additional outcomes included complications of RFA and number of sessions required to attain bleeding control. All data was summarized as median and interquartile ranges. Pre and post RFA periods were compared using sign rank test. All p values were two sided and considered significant when p!0.05. Results: 7 patients (5 men and 2 women), median age of 61 years (54-70 years), underwent 11 RFA sessions using channel RFA endoscopic catheter for treatment of UGIB during the study period. Indications for RFA included GAVE in 6 (86%), and AVM in 1(14%) patient. Of the 7 patients, 3 had received prior treatment with multiple APC sessions. In addition 1 patient had undergone both APC and RFA (x 1 session with HALO-90) in the past. Over a median follow-up period of 5 months, hemoglobin increased significantly in all the patients after RFA from 6.9 (6.5 - 8.1) gram/dl to 9 (8.7 - 11.5) gram/dl, (pZ0.027). A declining trend in transfusion requirement was observed from median 5 (0-28) transfusions in pre-RFA period to a median 0 (0 - 2) transfusions in post RFA period till now (pZ0.05). Two patients did not require any transfusion over 2 & 6 months of follow-up. No complications were reported in any of the sessions. Table 1 summarizes the patient demographics, prior treatment details, RFA sessions and outcomes of RFA treatment. Conclusions: RFA with “Channel RFA endoscopic catheter” is a safe and efficacious modality for management of upper GI bleed secondary to GAVE and AVM. It provides significant improvement in hemoglobin levels and decreases the requirement of blood transfusion. Future studies with longer follow-up are required to assess the long-term efficacy and safety.
Tu1737 Efficacy and Safety of Through the Scope “Channel RFA Endoscopic Catheter” in the Management of Upper GI Bleed. Ayush Arora, Sachin Batra, Moises I. Nevah, Atilla Ertan, Sushovan Guha, Andrew W. Dupont, Michael B. Fallon, Nirav Thosani* Gastroenterology, Hepatology and Nutrition, The University of Texas Health Science Center at Houston, Houston, TX Background: Gastric antral vascular ectasia (GAVE) and Arteriovenous Malformations (AVM) account for more than 4% cases of non variceal upper GI bleed (UGIB). Amongst endoscopic therapies, Argon plasma coagulation (APC) has been traditionally used for management of these conditions. Radiofrequency ablation (RFA) has been recently used in treatment of GAVE in few small studies. The safety and efficacy of Through the Scope “Channel RFA Endoscopic Catheter” (Covidien TTS1100) has not been previously studied. Aim: We evaluated the efficacy and safety of Channel RFA Endoscopic Catheter in management of UGIB due to GAVE and AVM.
Table 1. Outcomes of RFA with through the scope “Channerl RFA Endoscopic Catheter”
Age Sex Indication 70
m
GAVE
54
m
GAVE
61
f
GAVE
62
f
GAVE
56
m
GAVE
61
m
GAVE
64
m
AVM
Comorbidities HTN, GERD, h/o seizures, syncope, delirium, Diastolic HF Hepatic encephalopathy, POPH, Cirrhosis, Thrombocytopenia, Colon polyps, nonbleeding Esophageal varices Hepatitis C, Cirrhosis, Hepatic encephalopathy, CHF, DM, COPD, Hypothyroid, Hypertension COPD, CHF, HTN, Hypothyroidism, ESRD, Pulmonary Fibrosis, Adrenal Suppression Hepatitis C cirrhosis, varices, hepatic encephalopathy and HCC, COPD, Gastro paresis, Hemorrhoids Cirrhosis, CAD, ESRD, DM, HTN, Hypothyroidism, Hearing impairment Hepatitis C, Cirrhosis, Portal Hypertension, DM, p/h/o CHF
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Prior endoscopic therapy
Prior APC (n)
Prior RFA (n)
RFA Sessions (n)
Lesion SIte
Pre RFA Hgb
Post RFA Hgb
f/u Pre RFA Post RFA period Transfusion Transfusion Complications (months)
no
0
0
1
Antrum
10
un
5
0
no
4
yes
2
0
2
Antrum
6.5
8.7
15
2
no
6
yes
4
1
2
Antrum
5.8
8.6
28
2
no
5
yes
1
0
1
Antrum
11
un
0
0
no
5.5
no
0
0
1
Antrum
8.1
11.5
0
0
no
2
yes
3
0
3
Antrum
6.9
9
60
4
no
5
no
0
0
1
Fundus
13.1
13.8
0
0
no
0.5
Volume 81, No. 5S : 2015 GASTROINTESTINAL ENDOSCOPY AB577