Radiofrequency ablation for Barrett’s oesophagus related neoplasia with the 360 Express catheter: initial experience from the United Kingdom and Ireland—preliminary results
BACKGROUND: Radio-frequency ablation (RFA) for Barrett’s oesophagus (BE)-related neoplasia is currently used after endoscopic resection of visible neoplasia. The HALO 360 balloon has been used to ablate long segment BE. The Barrx™ 360 Express RFA self-sizing catheter (‘RFA Express’) may potentially...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer US
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8741663/ https://www.ncbi.nlm.nih.gov/pubmed/33547491 http://dx.doi.org/10.1007/s00464-021-08325-0 |
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author | Magee, Cormac G. Graham, David Gordon, Charles Dunn, Jason Penman, Ian Willert, Robert Smart, Howard Ortiz-Fernandez-Sordo, Jacobo Ragunath, Krish Everson, Martin Alzoubaidi, Durayd Banks, Matthew Morris, Danielle Sami, Sarmed Morris, Allan J. Bhandari, Pradeep Narayanasamy, Ravi Di Pietro, Massimiliano Lovat, Laurence B. Haidry, Rehan |
author_facet | Magee, Cormac G. Graham, David Gordon, Charles Dunn, Jason Penman, Ian Willert, Robert Smart, Howard Ortiz-Fernandez-Sordo, Jacobo Ragunath, Krish Everson, Martin Alzoubaidi, Durayd Banks, Matthew Morris, Danielle Sami, Sarmed Morris, Allan J. Bhandari, Pradeep Narayanasamy, Ravi Di Pietro, Massimiliano Lovat, Laurence B. Haidry, Rehan |
author_sort | Magee, Cormac G. |
collection | PubMed |
description | BACKGROUND: Radio-frequency ablation (RFA) for Barrett’s oesophagus (BE)-related neoplasia is currently used after endoscopic resection of visible neoplasia. The HALO 360 balloon has been used to ablate long segment BE. The Barrx™ 360 Express RFA self-sizing catheter (‘RFA Express’) may potentially allow quicker ablation times and improved treatment outcomes. The aim of this paper is to present real world data on the use of the 360 Express Device. METHODS: Centres in the UK and Ireland submitted cases where the RFA Express was used. The primary outcome was regression of BE at 3 months. Secondary outcomes were the rate of symptomatic stricture formation and resolution of intestinal metaplasia (CR-IM) and dysplasia (CR-D) at End of Treatment (EoT). RESULTS: 11 centres submitted 123 consecutive patients. 112 had a follow up endoscopy. The median age was 67 years (IQR 62–75). 3 dosimetries were used. The mean reduction in Circumferential (C) length was 78% ± 36 and mean reduction in Maximal length (M) was 55% ± 36. 17 patients (15%) developed strictures requiring dilation. There was a higher rate of stricture formation when the 12 J energy was used (p < 0.05). 47 patients had EoT biopsies, 40 (85%) had CR-D and 34(76%) had CR-IM. CONCLUSIONS: The RFA 360 Express catheter shows reduction in length of baseline BE at 3 months after index treatment, and eradication of intestinal metaplasia and dysplasia at 12 months similar to other studies with earlier devices. It appears that the symptomatic stricture rate is slightly higher than previous series with the HALO 360 catheter. This study was performed as part of the HALO registry and has been approved by the Research Ethics Committee - MREC Number 08/H0714/27 Local project reference 08/0104 Project ID 15,033 IRAS Number 54678 EudraCT 2009-015980-1. Registered on ISRCTN as below: ISRCTN93069556. https://doi.org/10.1186/ISRCTN93069556 |
format | Online Article Text |
id | pubmed-8741663 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-87416632022-01-20 Radiofrequency ablation for Barrett’s oesophagus related neoplasia with the 360 Express catheter: initial experience from the United Kingdom and Ireland—preliminary results Magee, Cormac G. Graham, David Gordon, Charles Dunn, Jason Penman, Ian Willert, Robert Smart, Howard Ortiz-Fernandez-Sordo, Jacobo Ragunath, Krish Everson, Martin Alzoubaidi, Durayd Banks, Matthew Morris, Danielle Sami, Sarmed Morris, Allan J. Bhandari, Pradeep Narayanasamy, Ravi Di Pietro, Massimiliano Lovat, Laurence B. Haidry, Rehan Surg Endosc Article BACKGROUND: Radio-frequency ablation (RFA) for Barrett’s oesophagus (BE)-related neoplasia is currently used after endoscopic resection of visible neoplasia. The HALO 360 balloon has been used to ablate long segment BE. The Barrx™ 360 Express RFA self-sizing catheter (‘RFA Express’) may potentially allow quicker ablation times and improved treatment outcomes. The aim of this paper is to present real world data on the use of the 360 Express Device. METHODS: Centres in the UK and Ireland submitted cases where the RFA Express was used. The primary outcome was regression of BE at 3 months. Secondary outcomes were the rate of symptomatic stricture formation and resolution of intestinal metaplasia (CR-IM) and dysplasia (CR-D) at End of Treatment (EoT). RESULTS: 11 centres submitted 123 consecutive patients. 112 had a follow up endoscopy. The median age was 67 years (IQR 62–75). 3 dosimetries were used. The mean reduction in Circumferential (C) length was 78% ± 36 and mean reduction in Maximal length (M) was 55% ± 36. 17 patients (15%) developed strictures requiring dilation. There was a higher rate of stricture formation when the 12 J energy was used (p < 0.05). 47 patients had EoT biopsies, 40 (85%) had CR-D and 34(76%) had CR-IM. CONCLUSIONS: The RFA 360 Express catheter shows reduction in length of baseline BE at 3 months after index treatment, and eradication of intestinal metaplasia and dysplasia at 12 months similar to other studies with earlier devices. It appears that the symptomatic stricture rate is slightly higher than previous series with the HALO 360 catheter. This study was performed as part of the HALO registry and has been approved by the Research Ethics Committee - MREC Number 08/H0714/27 Local project reference 08/0104 Project ID 15,033 IRAS Number 54678 EudraCT 2009-015980-1. Registered on ISRCTN as below: ISRCTN93069556. https://doi.org/10.1186/ISRCTN93069556 Springer US 2021-02-05 2022 /pmc/articles/PMC8741663/ /pubmed/33547491 http://dx.doi.org/10.1007/s00464-021-08325-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Magee, Cormac G. Graham, David Gordon, Charles Dunn, Jason Penman, Ian Willert, Robert Smart, Howard Ortiz-Fernandez-Sordo, Jacobo Ragunath, Krish Everson, Martin Alzoubaidi, Durayd Banks, Matthew Morris, Danielle Sami, Sarmed Morris, Allan J. Bhandari, Pradeep Narayanasamy, Ravi Di Pietro, Massimiliano Lovat, Laurence B. Haidry, Rehan Radiofrequency ablation for Barrett’s oesophagus related neoplasia with the 360 Express catheter: initial experience from the United Kingdom and Ireland—preliminary results |
title | Radiofrequency ablation for Barrett’s oesophagus related neoplasia with the 360 Express catheter: initial experience from the United Kingdom and Ireland—preliminary results |
title_full | Radiofrequency ablation for Barrett’s oesophagus related neoplasia with the 360 Express catheter: initial experience from the United Kingdom and Ireland—preliminary results |
title_fullStr | Radiofrequency ablation for Barrett’s oesophagus related neoplasia with the 360 Express catheter: initial experience from the United Kingdom and Ireland—preliminary results |
title_full_unstemmed | Radiofrequency ablation for Barrett’s oesophagus related neoplasia with the 360 Express catheter: initial experience from the United Kingdom and Ireland—preliminary results |
title_short | Radiofrequency ablation for Barrett’s oesophagus related neoplasia with the 360 Express catheter: initial experience from the United Kingdom and Ireland—preliminary results |
title_sort | radiofrequency ablation for barrett’s oesophagus related neoplasia with the 360 express catheter: initial experience from the united kingdom and ireland—preliminary results |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8741663/ https://www.ncbi.nlm.nih.gov/pubmed/33547491 http://dx.doi.org/10.1007/s00464-021-08325-0 |
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