Long-term results of treatment of vascular malformations of the gastrointestinal tract by neodymium YAG laser photocoagulation.

This study reports long-term results of treatment of vascular malformations of the gastrointestinal tract by neodymium YAG (Nd-YAG) laser photocoagulation in 60 patients (13 patients with hereditary hemorrhagic telangiectasia and 47 patients with angiodysplasias) and examines prognostic parameters of bleeding recurrence in 47 patients with angiodysplasias. In patients with hereditary hemorrhagic telangiectasia, the transfusion requirements were lower only in the second and third year following therapy than in the year before therapy; however, these differences were not significant. In patients with angiodysplasias, a median number of one laser session (range 1-8) was necessary to destroy angiodysplasias. A blood loss recurred in 15 patients. The cumulative probability of remaining free of blood loss recurrence at 24 months and at 54 months was 61 +/- 9%. Three parameters had an independent prognostic value, the initial number of angiodysplasias (P less than 0.02), the presence of coagulation disorders (P less than 0.05), and age (P less than 0.05).