Argon plasma coagulation

Argon plasma coagulation (APC) is a medical endoscopic procedure used to control bleeding from certain lesions in the gastrointestinal tract and to debulk tumours for which surgery is not recommended. It is administered during esophagogastroduodenoscopy or colonoscopy.

Argon plasma coagulation
Argon plasma coagulation administered via probe through the colonoscope at an angiodysplasia in the colon. The patient had multiple colonic angiodysplasiae in the setting of aortic stenosis.

Medical use

APC involves the use of a jet of ionized argon gas (plasma) directed through a probe passed through the endoscope. The probe is placed at some distance from the bleeding lesion, and argon gas is emitted, then ionized by a high-voltage discharge (approx 6kV).[1] High-frequency electric current is then conducted through the jet of gas, resulting in coagulation of the bleeding lesion. As no physical contact is made with the lesion, the procedure is safe if the bowel has been cleaned of colonic gases,[2][3] and can be used to treat bleeding in parts of the gastrointestinal tract with thin walls, such as the cecum. The depth of coagulation is usually only a few millimetres.

APC is used to treat the following conditions:

One of the complications of cirrhosis is constriction and twisting of blood vessels (varix) due to portal hypertension, including esophageal varices, gastric varices, and intestinal varices. The most common cause of death in cirrhosis is bleeding from varices. Closing off these varices with laser coagulation is one of the treatments that has been attempted.[4] It appears that endoscopic banding ligation in combination with argon plasma coagulation is one of the most successful approaches.[4]

See also

References

  1. "Post-Radiation Colitis". El Salvador Atlas of Gastrointestinal Video Endoscopy. Archived from the original on 3 July 2014.
  2. Ladas SD, Karamanolis G, Ben-Soussan E (October 2007). "Colonic gas explosion during therapeutic colonoscopy with electrocautery". World Journal of Gastroenterology. 13 (40): 5295–8. doi:10.3748/wjg.v13.i40.5295. PMC 4171316. PMID 17879396.
  3. Ben-Soussan E, Antonietti M, Savoye G, Herve S, Ducrotté P, Lerebours E (November 2004). "Argon plasma coagulation in the treatment of hemorrhagic radiation proctitis is efficient but requires a perfect colonic cleansing to be safe". European Journal of Gastroenterology & Hepatology. 16 (12): 1315–8. doi:10.1097/00042737-200412000-00013. PMID 15618838.
  4. Shi KQ, Liu WY, Pan ZZ, Ling XF, Chen SL, Chen YP, et al. (August 2013). "Secondary prophylaxis of variceal bleeding for cirrhotic patients: a multiple-treatments meta-analysis". European Journal of Clinical Investigation. 43 (8): 844–54. doi:10.1111/eci.12115. PMID 23725530.

Further reading

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