⁃ • Diagnosis of antral-predominant GAVE: Endoscopic confirmation of gastric-antral vascular ectasia affecting the antrum, without severe portal-hypertensive gastropathy. Sub-classify as nodular or non-nodular GAVE.

• Age: ≥ 18 years at the time of consent.

• Recent transfusion-dependent anemia

‣ ≥ 1 packed-RBC transfusion for GAVE-related bleeding within the last 6 months to maintain hemoglobin (Hgb) \> 8 g/dL (or \> 7 g/dL if no coronary/vascular disease).

⁃ Standard-of-care transfusion thresholds:

• If no coronary artery/vascular disease (CVD): transfuse 2 units when Hgb \< 7 g/dL.

∙ If CVD present: transfuse 2 units when Hgb \< 8 g/dL.

∙ After any transfusion, re-check Hgb within 1 week and repeat transfusion per the same criteria as needed.

• Documented transfusion history:

• o Medical records must show indication that each transfusion was for presumed GAVE-related bleeding.

• Treatment status:

• o Either treatment-naïve or ≤ 3 prior endoscopic ablation sessions for GAVE.

• Baseline data availability: Participant records must include endoscopic treatment dates, hemoglobin values, and transfusion data for 6 months prior to enrollment (extension up to 9 months permitted if data unavailable). Required elements:

‣ total number of transfusions,

⁃ total number of prior endoscopic treatments, and calculated change in hemoglobin from baseline: Δ Hgb = Hgb(T-6 mo) - Hgb(T0) \[extendable to Hgb(T-9 mo) if 6-month data are incomplete\]

• Capacity to consent: Able and willing to provide written informed consent.