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Review
. 2024 Oct;12(8):1128-1135.
doi: 10.1002/ueg2.12648. Epub 2024 Sep 4.

Recent advances in the treatment of refractory gastrointestinal angiodysplasia

Aymeric Becq  1 , Reena Sidhu  2   3 , Lia C M J Goltstein  4 , Xavier Dray  5
Affiliations
Review

Recent advances in the treatment of refractory gastrointestinal angiodysplasia

Aymeric Becq et al. United European Gastroenterol J. 2024 Oct.

Abstract

Gastrointestinal angiodysplasia (GIA) is a common, acquired, vascular abnormality of the digestive tract, and a frequent cause of bleeding. Refractory GIA criteria usually include recurrent bleeding, transfusions and/or repeat endoscopy. Pharmacological and interventional treatments have been the subject of recent high-quality publications. This review provides an overview of the latest updates on non-endoscopic management of refractory GIA. Aortic valve replacement has shown its efficacy in Heyde syndrome and should be considered if indicated. Anti-angiogenic drugs, such as Octreotide and Thalidomide, are efficient treatments of refractory GIA-related bleeding. Somatostatin analogs should, based on efficacy and tolerance profile, be considered first. In the future, a better understanding of the physiopathology of GIA might help develop new-targeted therapies.

Keywords: angiodysplasia; aortic valve replacement; bevacizumab; gastrointestinal bleeding; somatostatin analogs; thalidomide; transcatheter aortic valve implantation.

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Conflict of interest statement

Xavier Dray: Co‐founder and shareholder, Augmented Endoscopy; Teaching, Sandoz; Other authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Management algorithm of refractory angiodysplasia of the digestive tract. AVR, aortic valve replacement; IM, intramuscular; IV, intravenous; LAR, Long‐acting release; SC, subcutaneous; SB, small bowel.
See this image and copyright information in PMC

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