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SAN DIEGO -- In one of the first studies to characterize outcomes among patients diagnosed with angiodysplasia, researchers found that these individuals -- if they also have vascular disorders -- are more prone to bleeding that will require transfusions than other patients.

On multivariate analysis, patients with angidysplasia -- vascular lesions that occur in the gastrointestinal tract -- who were also diagnosed with melena had an eight-fold risk of requiring packed red blood cells transfusions in the next year, reported , resident physician at Loma Linda University Medical Center in California.

In her poster presentation at the annual Digestive Disease Week conference, Mai also found that patients with angiodysplasia and cardiovascular disease/coronary artery disease/peripheral artery disease had more than a six-fold risk of requiring blood transfusions.

The angiodysplasias, diagnosed via video capsule endoscopy, are similar to arteriovenous malformations which are often found in the brain and also are associated with bleeding risks, she told MedPage Today. "They are the most common lesions found in the gastrointestinal tract," she said.

Mai noted that in her "multiethnic, retrospective Veterans Affairs patient-based study, gastrointestinal angiodysplasia patients with concurrent vascular disease and melena were found to have higher transfusion rates than those patients without these comorbid illnesses. This relationship has not been reported previously.

"It is intuitive to think that because these lesions tend to bleed, then patients who have them would likely need more blood transfusions, and that is what we found," Mai said. "But there really isn't much written about this in the medical literature. I scoured the literature to find something on angiodysplasias and I could find very little. Prospective studies of larger populations are warranted to confirm this finding."

Mai and colleagues identified 425 patients who had video capsule endoscopy following occult bleeding episodes. "Capsule video endoscopy is really a very good way of detecting angiodysplasias," she said. These patients also underwent esophagogastroduodenoscopy and colonoscopy to determine the cause of these bleeding episodes. They found that 87 of these patients had small bowel gastrointestinal angiodysplasia.

Of that group, 48 patients had vascular disorders and 39 patients did not have vascular disorders. The patients with vascular disease were older -- 70 years versus 65 years (P=0.006); they were also more likely to be overweight (P=0.043). Patients who presented with vasculopathy were more likely to be diagnosed with hypertension, diabetes mellitus II and hyperlipidemia than their counterparts who were not diagnosed with vascular issues, Mai said.

She said that when angiodysplasias are identified there are various methods of treating them if they are deemed to be serious threat to the patients. She said the video capsule endoscopy is utilized if other imaging studies fail to find a bleeding cause. She said her next study will look at treatment of the angiodysplasias to determine how frequently the lesions are treated and what are the short-term and long-term results of those treatments.

In commenting on the study, Luke Tillman, MD, a resident in medicine at Northwestern Memorial Hospital, Chicago, said, "These lesions are known to be the causes of occult bleeding in the gastrointestinal tract. With additional ability to investigate the small bowel, I think we are learning more about angiodysplasia. There are now more ways to diagnose these lesions and we are developing more options for treating them."

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