Mucosal vascular malformations of the gastrointestinal tract: clinical observations and results of endoscopic neodymium:yttrium-aluminum-garnet laser therapy

C. J. Gostout, B. A. Bowyer, D. A. Ahlquist, T. R. Viggiano, R. K. Balm

Research output: Contribution to journalArticle

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Abstract

Ninety-three consecutive patients with transfusion-dependent gastrointestinal bleeding from vascular malformations (VMs) underwent systematic assessment in our gastrointestinal laser suite with extended upper gastrointestinal endoscopy and colonoscopy. Of these patients, 83 had angiodysplasia and 10 had the Osler-Weber-Rendu (OWR) syndrome. The median age in each of these groups was 70 and 63 years, respectively. Cardiovascular disease, especially valvular disease, was common. A poor correlation existed between the results of endoscopically identified VMs and visceral angiography in patients with angiodysplasia. A combination of upper and lower gastrointestinal VMs was found in 11% of patients with angiodysplasia and 60% of those with the OWR syndrome. All identified VMs were completely obliterated by photocoagulation with use of a neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. Bleeding was successfully controlled in 9 patients with the OWR syndrome and in 72 patients with angiodysplasia (range of follow-up, 1 to 39 months). In 243 laser treatments, 3 perforations and 5 episodes of delayed bleeding occurred. This experience demonstrates that extended upper endoscopy is useful in identifying VMs and that gastrointestinal bleeding from VMs can be safely and successfully controlled with use of endoscopic Nd:YAG laser therapy.

Original languageEnglish (US)
Pages (from-to)993-1003
Number of pages11
JournalMayo Clinic Proceedings
Volume63
Issue number10
StatePublished - 1988

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Neodymium
Vascular Malformations
Solid-State Lasers
Laser Therapy
Angiodysplasia
Gastrointestinal Tract
Hereditary Hemorrhagic Telangiectasia
Hemorrhage
Lasers
Gastrointestinal Endoscopy
Light Coagulation
Colonoscopy
Endoscopy
Angiography
Cardiovascular Diseases

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Mucosal vascular malformations of the gastrointestinal tract : clinical observations and results of endoscopic neodymium:yttrium-aluminum-garnet laser therapy. / Gostout, C. J.; Bowyer, B. A.; Ahlquist, D. A.; Viggiano, T. R.; Balm, R. K.

In: Mayo Clinic Proceedings, Vol. 63, No. 10, 1988, p. 993-1003.

Research output: Contribution to journalArticle

Gostout, C. J. ; Bowyer, B. A. ; Ahlquist, D. A. ; Viggiano, T. R. ; Balm, R. K. / Mucosal vascular malformations of the gastrointestinal tract : clinical observations and results of endoscopic neodymium:yttrium-aluminum-garnet laser therapy. In: Mayo Clinic Proceedings. 1988 ; Vol. 63, No. 10. pp. 993-1003.
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