Octreotide for AVM – pro
It is aclinical dilemma in patients with AVM on anti-coagulation, and concluded that it points toward the use of octreotide. Several other studies supportive of octreotide in general for AVM are referenced below. In his 2017 update, he concludes: ” Subcutaneous OCT therapy is an attractive option in AF patients receiving OAC who have AVM-related GI bleeds. It allows successful reinitiation of OAC as a bridge to left atrial appendage exclusion or short-term relief from bleeding. ” Further, is was supported by a meta-analysis by Shah in 2017, and most recently in a study of Standard of care vs. octreotide, by Goltstein et al in 2024.
Venkat Vuddand et al, Systemic Octreotide Therapy in Prevention of Gastrointestinal Bleeds Related to Arteriovenous Malformations and Obscure Etiology in Atrial Fibrillation. JACC: Clinical Electrophysiology
Volume 3, Issue 12, 11 December 2017, Pages 1390-1399.
Martins NB, Chaput KJ, Stawicki SP, Modi R. Octreotide as an adjunct in the management of arterial gastrointestinal bleeding: Should it be considered in refractory cases of obscure origin? Int J Crit Illn Inj Sci. 2017 Jan-Mar;7(1):8-11. doi: 10.4103/IJCIIS.IJCIIS_14_17. PMID: 28382252; PMCID: PMC5364774.
Stein, Adam MD1; Boike, Justin MD1; Jenkins, Erin MD2; Jeevanandam, Valluvan MD1; Reddy, K. MD1; Semrad, Carol MD1. Octreotide for Prevention of Repeat Gastrointestinal Bleeding in Patients With Left Ventricular Assist Device: Analysis of a Single-Center Cohort: 397. American Journal of Gastroenterology 109():p S120, October 2014.
Andrea Iannone, Mariabeatrice Principi, Michele Barone, Giuseppe Losurdo, Enzo Ierardi, Alfredo Di Leo, Gastrointestinal bleeding from vascular malformations: Is octreotide effective to rescue difficult-to-treat patients? Clinics and Research in Hepatology and Gastroenterology
Volume 40, Issue 4, September 2016, Pages 373-377.
Keyur B. Shah, MD, Sampath Gunda, MD, Sitaramesh Emani, MD, Manreet K. Kanwar, MD, Nir Uriel, MD, Paolo C. Colombo, MD, Patricia A. Uber, PharmD, Melissa L. Sears, RN, Joyce Chuang, PhD, David J. Farrar, PhD, Donald F. Brophy, PharmD, and George B. Smallfield, MD, Multicenter Evaluation of Octreotide as Secondary Prophylaxis in Patients With Left Ventricular Assist Devices and Gastrointestinal Bleeding. Circulation: Heart Failure, Vol 10, 2024