Commentary - (2025) Volume 10, Issue 1
Received: 01-Feb-2025, Manuscript No. cgj-25-161565;
Editor assigned: 03-Feb-2025, Pre QC No. P-161565;
Reviewed: 15-Feb-2025, QC No. Q-161565;
Revised: 20-Feb-2025, Manuscript No. R-161565;
Published:
27-Feb-2025
, DOI: 10.37421/2952-8518.2025.10.298
Citation: Narayanmurthy, Bhathi. “Modern Approaches to Gastric Arteriovenous Malformations: Diagnosis and Treatment.” Clin Gastroenterol J 10 (2025): 298.
Copyright: © 2025 Narayanmurthy B. This is an open-access article distributed under the terms of the creative commons attribution license which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Gastric arteriovenous malformations are rare vascular abnormalities that can occur in the stomach. They involve abnormal connections between arteries and veins, leading to the formation of tangled blood vessels. These AVMs can cause symptoms such as gastrointestinal bleeding, iron deficiency anemia, abdominal pain, and even life-threatening hemorrhage in severe cases. In recent years, there have been several advancements in the diagnosis and treatment of gastric AVMs, aimed at improving patient outcomes and reducing the risk of complications. However, in some adults, this anatomical variant persists .In certain cases, adults with the thyroid ima artery may present unique challenges related to hyperthyroidism [1,2].
Esophagogastroduodenoscopy (EGD) remains the primary diagnostic modality for gastric AVMs. It allows direct visualization of the abnormal blood vessels, assessment of bleeding severity, and targeted biopsy or therapeutic interventions. Chromoendoscopy: This technique involves the application of special dyes during endoscopy to enhance the visualization of abnormal blood vessels and improve diagnostic accuracy. EUS can help evaluate the depth of AVM involvement, assess adjacent structures, and guide therapeutic interventions.
Endoscopic interventions are the first-line treatment for gastric AVMs, especially in cases of active bleeding or high-risk lesions.. Laser ablation can be used to destroy abnormal blood vessels and promote hemostasis. Endoscopic resection: Surgical removal of small AVMs can be performed via endoscopy. Transcatheter arterial embolization minimally invasive procedure involves the injection of embolic agents into the arteries supplying the AVM, causing vessel occlusion and cessation of bleeding. Surgical resection: In cases where endoscopic therapies or TAE are unsuccessful or not feasible, surgical resection of the AVM may be necessary. This approach is typically reserved for large, complex, or high-risk lesions. Medical therapy: Although no specific medical treatment exists for gastric AVMs, certain medications such as proton pump inhibitors and iron supplements may be prescribed to manage associated symptoms and complications.
Radiofrequency ablation (RFA) is a newer endoscopic technique that uses thermal energy to ablate abnormal blood vessels. It has shown promise in the treatment of gastric AVMs, particularly smaller lesions. Cryotherapy involves freezing the AVM with liquid nitrogen or argon gas, leading to tissue necrosis and vessel destruction. It is another emerging endoscopic approach for managing gastric AVMs. Endoscopic mucosal resection and submucosal dissection advanced endoscopic techniques allow en bloc resection of larger AVMs with better visualization and lower recurrence rates. Blood Tests: Blood tests may be conducted to check for anemia or other abnormalities that could indicate gastrointestinal bleeding. Imaging Studies: Imaging techniques like angiography, computed tomography angiography (CTA), or magnetic resonance angiography (MRA) may be employed to visualize the blood vessels in the stomach and identify the presence of AVMs. Upper gastrointestinal endoscopy is a key diagnostic tool for gastric AVMs. It involves the insertion of a flexible tube with a camera (endoscope) into the esophagus and stomach to directly visualize the AVMs and assess their characteristics [3].
The selection of vessels for embolization depends on the individual patient's vascular anatomy and the therapeutic goals. Each case requires careful assessment and consideration of the best approach to achieve the desired outcomes. Consulting with an interventional radiologist or a qualified healthcare professional experienced in thyroid embolization is crucial in making appropriate treatment decisions based on the specific circumstances of the patient. Gastric arteriovenous malformations (AVMs) are abnormal tangles of blood vessels that form in the stomach. These malformations can lead to various symptoms such as gastrointestinal bleeding, iron deficiency anemia, and abdominal pain. Diagnosis and treatment of gastric AVMs typically involve a combination of imaging studies, endoscopy, Medical History and Physical Examination: The doctor will begin by taking a detailed medical history and performing a physical examination to assess the patient's symptoms and overall health [4,5].
Invasive approaches, improved success rates in achieving hemostasis, and reduced morbidity and mortality associated with these challenging vascular lesions. However, the choice of treatment depends on factors such as the size and location of the AVM, severity of bleeding, and patient characteristics, and should be tailored to individual cases.
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Clinical Gastroenterology Journal received 33 citations as per Google Scholar report
