Current evidence on radiofrequency ablation for gastric antral vascular ectasia raises no major safety concerns; however, evidence on its efficacy is inadequate in quantity. Therefore, this procedure should only be used with special arrangements for clinical governance, consent and audit or research.
Clinicians wishing to undertake radiofrequency ablation for gastric antral vascular ectasia should take the following actions:
Inform the clinical governance leads in their NHS trusts.
Ensure that patients understand the uncertainty about the procedure's safety and efficacy and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.
Audit and review clinical outcomes of all patients having radiofrequency ablation for gastric antral vascular ectasia (see section 7.1).
The procedure should only be done by experienced interventional endoscopists with specific training in the technique.
NICE encourages further research into radiofrequency ablation for gastric antral vascular ectasia and collaborative publication of data from local audit. Patient selection should be clearly documented, including details of prior treatments. Outcomes should include success and duration of effect in controlling bleeding and the effect of this on the need for blood transfusion. All complications should be reported. NICE may update the guidance on publication of further evidence.