What is coagulation with argon plasma (CAP)?
The CAP is a coagulation method of “no contact” that uses an electric current in the presence of argon gas to distribute heat evenly on the tissue adjacent to the tip of the coagulation instrument. A flexible tube is introduced through the endoscope into the interior of the digestive system, and can be used to cover wide areas of tissue rapidly. The deepness of penetration in the tissue can be controlled by duration of application, power, and flow, ranging from 1-3 mm.
An evaluation report of current technologies of the American Society of Gastrointestinal Endoscopy arrived to the conclusion that CAP is the most adequate method for homeostasis of diffuse vascular superficial lesions as is the vascular ectasia syndrome of the gastric antrum and the chronic proctitis induced post-radiation. The anatomy of arteriovenous formation makes them adequate targets for treatment with CAP. The rate of immediate homeostasis ranged from 85-100% in the varied reports, and treatment resulted in long-term bleeding control.
The CAP is also used to coagulate the base of large polyps as it eliminate residual malign tissue and controls bleeding.
The CAP is also widely used as an alternative to lazer and bipolar cauterization for the resection of tumors that have grown into the stents previously placed in the digestive system, and as a tool to stop generalized bleeding of tumors.
What are the indications for the use of CAP Some of the current applications of CAP are:
Homeostasis:
- Bleeding ulcers
- Post-radiation ulcers
- Bleeding varicose veins
- Vascular ectasia
- Radio therapy-induced hemorrhage
Ablation:
- Polyps
- Reduction of malignant tumors
- Dysplasic heterotypic mucosa
- Re-channel stents obstructed by tumor
