An overview of angiodysplasia: management and patient prospects

References

• Regula J, Wronska E, Pachlewski J. Vascular lesions of the gastrointestinal tract. Best Pract Res Clin Gastroenterol. 2008;22(2):313–328.
   PubMed Web of Science ®Google Scholar
• Rockey DC, Koch J, Cello JP, et al. Relative frequency of upper gastrointestinal and colonic lesions in patients with positive fecal-occult blood tests. N Eng J Med. 1998;339:153–159.
   PubMed Web of Science ®Google Scholar
• Schmit A, Gay F, Adler M, et al. Diagnostic efficacy of push enteroscopy and long term follow up of patients with small bowel angiodysplasia. Dig Dis Sci. 1996;41:2348–2352.
   PubMed Web of Science ®Google Scholar
• Sami SS, Al-Araji SA, Ragunath K. Review article: gastrointestinal angiodysplasia - pathogenesis, diagnosis and management. Aliment Pharmacol Ther. 2014;39:15–34.
   PubMed Web of Science ®Google Scholar
• Dray X, Camus M, Coelho J, et al. Treatment of gastrointestinal angiodysplasia and unmet needs. Dig Liver Dis. 2011 Jul;43(7):515–522. Epub 2011 Jan 15.
   PubMedGoogle Scholar
• Bollinger E, Raines D, Saitta P. Distribution of bleeding gastrointestinal angioectasias in a Western population. World J Gastroenterol. 2012 Nov 21;18(43):6235–6239.
   PubMed Web of Science ®Google Scholar
• Holleran G, Hall B, Zgaga L, et al. The natural history of small bowel angiodysplasia. Scand J Gastroenterol. 2016;51(4):393–399.
   PubMed Web of Science ®Google Scholar
• Boley SJ, Sammartano R, Adams A, et al. On the nature and etiology of vascular ectasias of the colon. Degenerative lesions of aging. Gastroenterology. 1977;72:650–660.
   PubMed Web of Science ®Google Scholar
• Baum S, Athanasoulis CA, Waltman AC, et al. Angiodysplasia of the right colon: a cause of gastrointestinal bleeding. AJR Am J Roentgenol. 1977 Nov;129(5):789–794.
   PubMed Web of Science ®Google Scholar
• Junquera F, Saperas E, De Torres I, et al. Increased expression of angiogenic factors in human colonic angiodysplasia. Am J Gastroenterol. 1999;94:1070–1076.
   PubMed Web of Science ®Google Scholar
• Holleran G, Hall B, O’Regan M, et al. Expression of angiogenic factors in patients with sporadic small bowel angiodysplasia. J Clin Gastroenterol. 2015 Nov-Dec;49(10):831–836.
   PubMed Web of Science ®Google Scholar
• Nardone G, Compare D, Scarpignato C, et al. Long acting release-octreotide as “rescue” therapy to control angiodysplasia bleeding: a retrospective study of 98 cases. Dig Liver Dis. 2014 Aug;46(8):688–694.
   PubMedGoogle Scholar
• Lecleire S, Iwanicki-Caron I, Di-Fiore A, et al. Yield and impact of emergency capsule enteroscopy in severe obscure-overt gastrointestinal bleeding. Endoscopy. 2012;44:337–342.
   PubMed Web of Science ®Google Scholar
• Ueno S, Nakase H, Kasahara K, et al. Clinical features of Japanese patients with colonic angiodysplasia. J Gastroenterol Hepatol. 2008 Aug;23(8 Pt 2):e363–e366.
   PubMed Web of Science ®Google Scholar
• Igawa A, Oka S, Tanaka S, et al. Major predictors and management of small-bowel angioectasia. BMC Gastroenterol. 2015;15:108.
   PubMed Web of Science ®Google Scholar
• Richter JM, Christensen MR, Colditz GA, et al. Angiodysplasia. Natural history and efficacy of therapeutic interventions. Dig Dis Sci. 1989;34:1542–1546.
   PubMed Web of Science ®Google Scholar
• May A, Friesing-Sosnik T, Manner H, et al. Long-term outcome after argon plasma coagulation of small-bowel lesions using double balloon enteroscopy in patients with mid gastrointestinal bleeding. Endoscopy. 2011;43:759–765.
   PubMed Web of Science ®Google Scholar
• Grooteman KV, Van Geenen EJ, Drenth JP. High variation in treatment strategies for gastrointestinal angiodysplasias. Eur J Gastroenterol Hepatol. 2016 Sep;28(9):1082–1086.
   PubMed Web of Science ®Google Scholar
• Swanson E, Mahgoub A, MacDonald R, et al. Medical and endoscopic therapies for angiodysplasia and gastric antral vascular ectasia: a systematic review. Clin Gastroenterol Hepatol. 2014;12:571–582.
   PubMed Web of Science ®Google Scholar
• Vargo JJ. Clinical applications of the argon plasma coagulator. Gastrointest Endosc. 2004;59:81–88.
   PubMed Web of Science ®Google Scholar
• Olmos JA, Marcolongo M, Pogorelsky V, et al. Long-term outcome of argon plasma ablation therapy for bleeding in 100 consecutive patients with colonic angiodysplasia. Dis Colon Rectum. 2006;49:1507–1516.
   PubMed Web of Science ®Google Scholar
• Olmos JA, Marcolongo M, Pogorelsky V, et al. Argon plasma coagulation for prevention of recurrent bleeding from GI angiodysplasias. Gastrointest Endosc. 2004;60:881–886.
   PubMed Web of Science ®Google Scholar
• May A, Friesing-Sosnik T, Manner H, et al. Long-term outcome after argon plasma coagulation of small-bowel lesions using double-balloon enteroscopy in patients with mid-gastrointestinal bleeding. Endoscopy. 2011 Sep;43(9):759–765.
   PubMed Web of Science ®Google Scholar
• Rahmi G, Samaha E, Vahedi K, et al. Long-term follow-up of patients undergoing capsule and double-balloon enteroscopy for identification and treatment of small-bowel vascular lesions: a prospective, multicenter study. Endoscopy. 2014 Jul;46(7):591–597.
   PubMed Web of Science ®Google Scholar
• Landi B, Cellier C, Gaudric M, et al. Long-term outcome of patients with gastrointestinal bleeding of obscure origin explored by push enteroscopy. Endoscopy. 2002 May;34(5):355–359.
   PubMed Web of Science ®Google Scholar
• Samaha E, Rahmi G, Landi B, et al. Long-term outcome of patients treated with double balloon enteroscopy for small bowel vascular lesions. Am J Gastroenterol. 2012 Feb;107(2):240–246.
   PubMed Web of Science ®Google Scholar
• Bauditz J, Lochs H, Voderholzer W. Macroscopic appearance of intestinal angiodysplasias under antiangiogenic treatment with thalidomide. Endoscopy. 2006;38:1036–1039.
   PubMed Web of Science ®Google Scholar
• Bauditz J, Lochs H. Angiogenesis and vascular malformations: antiangiogenicdrugs for treatment of gastrointestinal bleeding. World J Gastroenterol. 2007;13:5979–5984.
   PubMed Web of Science ®Google Scholar
• Moschler O, May AD, Muller MK, et al. Complications in double balloon enteroscopy: results of the German DBE registry (in German). Z Gastroenterol. 2008;46:266–270.
   PubMed Web of Science ®Google Scholar
• Suzuki N, Arebi N, Saunders BP. A novel method of treating colonic angiodysplasia. Gastrointest Endosc. 2006;64:424–427.
   PubMed Web of Science ®Google Scholar
• Kwan V, Bourke MJ, Williams SJ, et al. Argon plasma coagulation in the management of symptomatic gastrointestinal vascular lesions: experience in 100 consecutive patients with long-term follow-up. Am J Gastroenterol. 2006;101:58–63.
   PubMed Web of Science ®Google Scholar
• Junquera F, Brullet E, Campo R, et al. Usefulness of endoscopic band ligation for bleeding small bowel vascular lesions. Gastrointest Endosc. 2003;58:274–279.
   PubMed Web of Science ®Google Scholar
• Rutgeerts P, Van Gompel F, Geboes K, et al. Long-term results of treatmets of vascular malformations of the gastrointestinal tract by neodymium YAG laser photocoagulation. GUT. 1985;26:586–593.
   PubMed Web of Science ®Google Scholar
• Harrison DF. Use of estrogen in treatment of familial hemorrhagic telangiectasia. Laryngoscope. 1982;92:314–320.
   PubMed Web of Science ®Google Scholar
• Szilagyi A, Ghali MP. Pharmacological therapy of vascular malformations of the gastrointestinal tract. Can J Gastroenterol. 2006 Mar;20(3):171–8. Review.
   PubMed Web of Science ®Google Scholar
• Junquera F, Santos J, Saperas E, et al. Estrogen and progestagen treatment in digestive hemorrhage caused by vascular malformations. Gastroenterol Hepatol. 1995 Feb;18(2):61–65.
   PubMedGoogle Scholar
• Barkin JS, Ross BS. Medical therapy for chronic gastrointestinal bleeding of obscure origin. Am J Gastroenterol. 1998;93:1250–1254.
   PubMed Web of Science ®Google Scholar
• Van Cutsem E, Rutgeert P, Vantrappen G. Long-term effect of hormonal therapy for bleeding gastrointestinal vascular malformations. Eur J Gastroenterol Hepatol. 1993;5:439–443.
   Web of Science ®Google Scholar
• Carey EJ, Leighton JA, Heigh RI, et al. A single-center experience of 260 consecutive patients undergoing capsule endoscopy for obscure gastrointestinal bleeding. Am J Gastroenterol. 2007;102:89–95.
   PubMed Web of Science ®Google Scholar
• Bauditz J, Schachschal G, Wedel S, et al. Thalidomide for treatment of severe intestinal bleeding. Gut. 2004;53:609–612.
   PubMed Web of Science ®Google Scholar
• Shurafa M, Kamboj G. Thalidomide for the treatment of bleeding angiodysplasias. Am J Gastroenterol. 2003;98:221–222.
   PubMed Web of Science ®Google Scholar
• De Koning DB, Drenth JP, Friederich P, et al. Thalidomide for the treatment of recurrent gastrointestinal blood loss due to intestinal angiodysplasias. Ned Tijdschr Geneeskd. 2006;150:1994–1997.
   PubMedGoogle Scholar
• Kamalaporn P, Saravanan R, Cirocco M, et al. Thalidomide for the treatment of chronic gastrointestinal bleeding from angiodysplasias: a case series. Eur J Gastroenterol Hepatol. 2009 Dec;21(12):1347–1350.
   PubMed Web of Science ®Google Scholar
• Fernández Salazar LI, Velayos Jiménez B, Fernández Galante I, et al. Efficacy of thalidomide in digestive bleeding caused by angiodysplasias. Rev Esp Enferm Dig. 2009 May;101(5):371.
   PubMed Web of Science ®Google Scholar
• Ge ZZ, Chen HM, Gao YJ, et al. Efficacy of thalidomide for refractory gastrointestinal bleeding from vascular malformation. Gastroenterology. 2011 Nov;141(5):1629–37, e1–4.
   PubMed Web of Science ®Google Scholar
• Bauditz J, Lochs H, Voderholzer W. Macroscopic appearance of intestinal angiodysplasias under antiangiogenic treatment with thalidomide. Endoscopy. 2006;38:1036–1039.
   PubMed Web of Science ®Google Scholar
• Izquierdo Navarro MC, Hernando Verdugo M, Cardaba Garcia E, et al. Therapeutic failure with thalidomide in patients with recurrent intestinal bleeding due to angiodysplasias. Farm Hosp. 2016;40:230–232.
   PubMedGoogle Scholar
• Kurosaki M, Saegert W, Abe T, et al. Expression of vascular endothelial growth factor in growth hormone-secreting pituitary adenomas: special reference to the octreotide treatment. Neurol Res. 2008;30:518–522.
   PubMed Web of Science ®Google Scholar
• Ludwig D, Terai S, Bruning A, et al. Long-term haemodynamic effects of octreotide on postprandial splanchnic hyperemia in humans: a placebocontrolled echo-doppler study. Aliment Pharmacol Ther. 1999;13:1119–1129.
   PubMed Web of Science ®Google Scholar
• Brown C, Subramanian V, Wilcox CM, et al. Somatostatin analogues in the treatment of recurrent bleeding from gastrointestinal vascular malformations: an overview and systematic review of prospective observational studies. Dig Dis Sci. 2010 Aug;55(8):2129–2134.
   PubMed Web of Science ®Google Scholar
• Junquera F, Saperas E, Videla S, et al. Long-term efficacy of octreotide in the prevention of recurrent bleeding from gastrointestinal angiodysplasia. Am J Gastroenterol. 2007;102:254–260.
   PubMed Web of Science ®Google Scholar
• Nardone G, Rocco A, Balzano T, et al. The efficacy of octreotide therapy in chronic bleeding due to vascular abnormalities of the gastrointestinal tract. Aliment Pharmacol Ther. 1999 Nov;13(11):1429–1436.
   PubMed Web of Science ®Google Scholar
• Scaglione G, Pietrini L, Russo F, et al. Long-acting octreotide as rescue therapy in chronic bleeding from gastrointestinal angiodysplasia. Aliment Pharmacol Ther. 2007;26:935–942.
   PubMed Web of Science ®Google Scholar
• Molina IJ, Perez GB, Hernandez AM, et al. Octreotide long acting release for severe obscure gastrointestinal haemorrhage in elderly patients with serious comorbidities. Med Clin (Barc). 2009;133:667–670.
   PubMed Web of Science ®Google Scholar
• Bon C, Aparicio T, Vincent M, et al. Long-acting somatostatin analogues decrease blood transfusion requirements in patients with refractory gastrointestinal bleeding associated with angiodysplasia. Aliment Pharmacol Ther. 2012 Sep;36(6):587–593.
   PubMed Web of Science ®Google Scholar
• Holleran G, Hall B, Breslin N, et al. Long-acting somatostatin analogues provide significant beneficial effect in patients with refractory small bowel angiodysplasia: results from a proof of concept open label mono-centre trial. United European Gastroenterol J. 2016 Feb;4(1):70–76.
   PubMed Web of Science ®Google Scholar
• Grooteman KV, Van Geenen EJ, Drenth JP. Multicentre, open-label, randomised, parallel-group, superiority study to compare the efficacy of octreotide therapy 40 mg monthly versus standard of care in patients with refractory anaemia due to gastrointestinal bleeding from small bowel angiodysplasias: a protocol of the OCEAN trial. BMJ Open. 2016 Sep 12;6(9):e011442. doi:10.1136/bmjopen-2016-011442
   PubMed Web of Science ®Google Scholar
• Benamouzig R, Benallaoua M, Saurin JC, et al. Efficacy and safety of pasireotide-LAR for the treatment of refractory bleeding due to gastrointestinal angiodysplasias: results of the ANGIOPAS multicenter phase II noncomparative prospective double-blinded randomized study. Therap Adv Gastroenterol. 2018 Feb;16(11):1756283X18756260.
   Google Scholar
• Hawkey GM, Cole AT, McIntyre AS, et al. Drug treatments in upper gastrointestinal bleeding: value of endoscopic findings as surrogate end points. Gut. 2001;49:372–379.
   PubMed Web of Science ®Google Scholar
• Von Holstein CC, Eriksson SB, Kallen R. Tranexamic acid as an aid to reducing blood transfusion requirements in gastric and duodenal bleeding. BMJ. 1987;294:7–10.
   PubMedGoogle Scholar
• Ker K, Edwards P, Perel P, et al. Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis. BMJ. 2012;344:e3054.
   PubMed Web of Science ®Google Scholar
• Grooteman KV, Ejm VG, Drenth JPH. Tranexamic acid in treatment-resistant chronic transfusion-dependent gastrointestinal angiodysplasia bleeding. BMJ Case Rep. 2017 Nov 1;2017. pii: doi:10.1136/bcr-2017-221832
   PubMedGoogle Scholar
• Manno D, Ker K, Roberts I. How effective is tranexamic acid for acute gastrointestinal bleeding? BMJ. 2014 Feb;17(348):g1421.
   Google Scholar
• Marlu R, Barthelon J, Durand A, et al. Long-term therapy with bevacizumab in a patient with Glanzmann’s thrombasthenia and recurrent digestive bleeding due to gastrointestinal angiodysplastic lesions. Am J Gastroenterol. 2015 Feb;110(2):352–353.
   PubMed Web of Science ®Google Scholar
• Fiorito JJ, Brandt LJ, Kozicky O, et al. The diagnostic yield of superior mesenteric angiography: correlation with the pattern of gastrointestinal bleeding. Am J Gastroenterol. 1989 Aug;84(8):878–881.
   PubMed Web of Science ®Google Scholar
• Pai M, Frampton AE, Virk JS, et al. Preoperative superselective mesenteric angiography and methylene blue injection for localization of obscure gastrointestinal bleeding. JAMA Surg. 2013 Jul;148(7):665–668.
   PubMed Web of Science ®Google Scholar
• Cappell MS, Gupta A. A changing epidemiology of gastrointestinal angiodysplasia with increasing recognition of clinically milder cases: angiodysplasia tend to produce mild chronic gastrointestinal bleeding in a study of 47 consecutive patients admitted from 1980–1989. Am J Gastroenterology. 1992;87:201–206.
   PubMed Web of Science ®Google Scholar
• Kheterpal S. Angiodysplasia; a review. Journal of the Royal Soc Med. 1991;84:615–618.
   PubMed Web of Science ®Google Scholar
• Kim DB, Chung WC, Lee SJ, et al. Analysis of risk factor and clinical characteristics of angiodysplasia presenting as upper gastrointestinal bleeding. Korean J Intern Med. 2016 Jul;31(4):669–677.
   PubMed Web of Science ®Google Scholar
• Werkentin TE, Moore JC, Anand SS, et al. Gastrointestinal bleeding; angiodysplasia, cardiovascular disease and acquired von Willebrand syndrome. Transfusion Med Rev. 2003;4:272–286.
   Google Scholar
• Sieg AC, Moretz JD, Horn E, et al. Pharmacotherapeutic management of gastrointestinal bleeding in patients with continuous-flow left ventricular assist devices. Pharmacotherapy. 2017 Nov;37(11):1432–1448.
   PubMed Web of Science ®Google Scholar
• Cochrane J, Jackson C, Schlepp G, et al. Gastrointestinal angiodysplasia is associated with significant gastrointestinal bleeding in patients with continuous left ventricular assist devices. Endosc Int Open. 2016 Mar;4(3):E371–E377.
   PubMed Web of Science ®Google Scholar
• Kang J, Hennessy-Strahs S, Kwiatkowski P, et al. Continuous-flow LVAD support causes a distinct form of intestinal angiodysplasia. Circ Res. 2017 Sep 29;121(8):963–969.
   PubMed Web of Science ®Google Scholar
• Gordon FH, Watkinson A, Hodgson H. Vascular malformations of the gastrointestinal tract. Best Pract Res Clin Gastroenterol. 2001;15:41–58.
   PubMed Web of Science ®Google Scholar
• Holleran G, Hall B, Hussey M, et al. Small bowel angiodysplasia and novel disease associations: a cohort study. Scand J Gastroenterol. 2013 Apr;48(4):433–438.
   PubMed Web of Science ®Google Scholar
• Foutch PG, Rex DK, Lieberman DA. Prevalence and natural history of colonic angiodysplasia among healthy asymptomatic people. Am J Gastroenterol. 1995;90:564–567.
   PubMed Web of Science ®Google Scholar
• Jackson CS, Gerson LB. Management of gastrointestinal angiodysplastic lesions (GIADs): a systematic review and meta-analysis. Am J Gastroenterol. 2014 Apr;109(4):474–483. quiz 484.
   PubMed Web of Science ®Google Scholar
• Foutch PG, Rex DK, Lieberman DA. Prevalence and natural history of colonic angiodysplasia among healthy asymptomatic people. Am J Gastroenterol. 1995 Apr;90(4):564–567.
   PubMed Web of Science ®Google Scholar
• Nishimura N, Mizuno M, Shimodate Y, et al. Risk factors for active bleeding from colonic angiodysplasia confirmed by colonoscopic observation. Int J Colorectal Dis. 2016 Dec;31(12):1869–1873.
   PubMed Web of Science ®Google Scholar
• Grooteman KV, Matheeuwsen M, Van Geenen EJM, et al. Decreased health-related quality of life in angiodysplasia patients: A cross-sectional cohort. PLoS One. 2017 May 26;12(5).
   PubMed Web of Science ®Google Scholar
• Roskell DE, Biddolph SC, Warren B F. Apparent deficiency of mucosal vascular collagen type IV associated with angiodysplasia of the colon. J Clin Pathol. 1998 January;51(1):18–20.
   PubMed Web of Science ®Google Scholar
• Heyde EC. Gastrointestinal bleeding in aortic stenosis. N Engl J Med. 1958;259(4):196.
   Web of Science ®Google Scholar
• Bouïs D, Kusumanto Y, Meijer C, et al. A review on pro- and anti-angiogenic factors as targets of clinical intervention. Pharmacol Res. 2006 Feb;53(2):89–103.
   PubMed Web of Science ®Google Scholar
• Ferrara N, Gerber HP, LeCouter J. The biology of VEGF and its receptors. Nat Med. 2003;9:669–676.
   PubMed Web of Science ®Google Scholar
• Ojeda-Fernandez L, Barrios L, Rodriguez-Barbero A, et al. Reduced plasma levels of Ang-2 and sEng as novel biomarkers in hereditary hemorrhagic telangiectasia (HHT). Clin Chim Acta. 2010 Apr 2;411(7–8):494–499.
   PubMed Web of Science ®Google Scholar
• Lebrin F, Goumans MJ, Jonker L, et al. Endoglin promotes endothelial cell proliferation and TGF-beta/ALK1 signal transduction. EMBO J. 2004 Oct 13;23(20):4018–4028.
   PubMed Web of Science ®Google Scholar
• Fagiani E, Christofori G. Angiopoietins in angiogenesis. Cancer Lett. 2013 Jan 1;328(1):18–26.
   PubMed Web of Science ®Google Scholar
• Fiedler U, Scharpfenecker M, Koidl S, et al. The Tie-2 ligand angiopoietin-2 is stored in and rapidly released upon stimulation from endothelial cell Weibel-Palade bodies. Blood. 2004 Jun 1;103(11):4150–4156.
   PubMed Web of Science ®Google Scholar
• Randi AM, Laffan MA, Starke RD. Von Willebrand factor, angiodysplasia and angiogenesis. Mediterr J Hematol Infect Dis. 2013 Sep 2;5(1):e2013060. doi:10.4084/MJHID.2013.060.
   PubMedGoogle Scholar
• Holleran G, Hussey M, Smith S, et al. Assessment of serum angiogenic factors as a diagnostic aid for small bowel angiodysplasia in patients with obscure gastrointestinal bleeding and anaemia. World J Gastrointest Pathophysiol. 2017 Aug 15; 8(3):127–132.
   PubMedGoogle Scholar