Novel Use of Radiofrequency Ablation in the Treatment of AVMs of Small Bowel Mucosa: 2657

INTRODUCTION: Radiofrequency ablation (RFA) is a well-authorized treatment in a number of gastrointestinal conditions such as dysplastic Barrett’s, gastric antral vascular ectasia and biliary stricture. We are presenting a case series focused on the use of RFA in the treatment of small bowel AVMs through small bowel enteroscopy, using a novel through the scope radio frequency ablation catheter. CASE DESCRIPTION/METHODS: Cases: This case series encompasses five cases using a new through the scope radio frequency ablation caterer to treat AVMs found in the small bowel and cecum. The age for these patients ranged from 56 to 72 years old, with two being males and three being females. Our patients presented for various reasons, including abdominal pain, abnormal CT findings, and gastrointestinal bleeding. Colonoscopies and endoscopies on these patients were unremarkable. All patients underwent single balloon enteroscopy, and multiple arteriovenous malformations (AVMs) were found. AVMs were successfully ablated using a novel through the scope radio frequency ablation catheter (RFA-SB). AVMs in these patients were found in the cecum, jejunum, ileum and stomach. 12 J/cm2 energy was applied with each paddle application. All patients recovered well after the procedure and follow up CBC showed improvement in their hematocrit. No immediate or late procedure related complications were reported. DISCUSSION: AVMs are one of the common causes of gastrointestinal bleeding. Ablation of AVMs in the small bowel has typically utilized argon plasma coagulation (APC) as a treatment modality. This case series looks at the use of a new RFA-SB as a new treatment modality for small bowel AVMs. This series is novel, due to the length of the new RFA catheter, as it is able to pass through a 200 cm small bowel enteroscope with better maneuverability and providing a uniform therapy than traditionally used APC technique without healthy tissue damage and achieving satisfactory hemostasis.