Clinical applications of the argon plasma coagulator

  • Vargo J
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The APC is a non-contact method of endoscopically delivered high-frequency thermal coagulation. The level of evidence and the range of APC settings in the published studies for each indication are presented in Table 4. The majority of the published clinical experience is in the realm of case series. However a few, albeit small randomized controlled trials have emerged. The APC appears most efficacious in the treatment of vascular lesions such as radiation proctopathy and GAVE. However, there is insufficient comparative data with other established treatment modalities such as the heater probe, bipolar coagulation probe, and the Nd:YAG laser. Though there is some data to suggest that the APC may be useful in the treatment of peptic ulcer disease and as adjuvant therapy to prevent esophageal variceal recurrence, it must be emphasized that these data are generated from small randomized controlled trials, and, therefore, such treatment should be considered experimental until larger trials validate these findings. There are no cost-effectiveness studies to date with the APC, and studies addressing the economic impact of APC from an institutional and patient perspective are needed.

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