Digestive angiodysplasias are acquired vascular malformations responsible for chronic or acute gastrointestinal bleeding, mainly affecting elderly and polymorbid patients. Diagnosis relies primarily on endoscopy, and argon plasma coagulation (APC) is the standard therapeutic approach. However, the recurrence risk remains high and depends on several clinical and lesion-related factors. The aim of this study was to identify the therapeutic and clinical outcome determinants of digestive angiodysplasias, to assess the efficacy of endoscopic APC, and to analyze factors associated with recurrence.

We conducted a retrospective, descriptive, and analytical study at a university hospital, including 79 patients treated with APC for endoscopically confirmed digestive angiodysplasias between January 2022 and June 2025. Clinical and endoscopic data were reviewed, and treatment details, immediate efficacy, clinical improvement, and recurrence were recorded. Statistical analyses were performed to identify factors associated with therapeutic response and recurrence.

The median age was 75 years, with a male predominance (59.5%). The most common comorbidities were hypertension (68.4%), diabetes (34.2%), coronary artery disease (27.8%), and renal insufficiency (20.3%). Anemia was the most frequent presenting symptom (67.1%), followed by rectal bleeding (46.8%). Lesions were predominantly located in the cecum. All patients underwent APC treatment, mostly in a single session. Immediate efficacy was achieved in most cases, and a significant clinical improvement was observed in 59.5% of patients. However, bleeding recurrence occurred in nearly half of cases, with a mean delay of 5.5 months. A better prognosis was observed in patients with localized involvement and a limited number of lesions, whereas multi-segmental disease, multiple lesions, and duodenal or jejunal localizations were significantly linked to higher recurrence rates.

In our series, argon plasma coagulation was effective as a first-line treatment for digestive angiodysplasias, providing significant clinical improvement in most patients. Despite this, recurrence of bleeding remained relatively common, particularly in patients with multiple lesions or duodenojejunal involvement. Patients with localized and limited lesions experienced a better prognosis, highlighting the importance of careful endoscopic evaluation and close follow-up, especially for those at higher risk of recurrence.