Introduction Radio-frequency ablation (RFA) for the treatment of Barrett’s oesophagus (BE) related neoplasia has become the preferred ablative intervention after endoscopic resection (ER) over the past decade. For circumferential BE, the 3 cm HALO 360 balloon can be used to treat large areas. A new device, HALO 360 Express self-sizing catheter was recently launched and can potentially allow quicker ablation times and better coverage of the mucosa due to the improved tissue/catheter contact and 4 cm balloon length.
Method Specialist centres in the UK and Ireland submitted cases where Halo 360 express had been used.
Patients returned for follow up at 3 months after index RFA express treatment. They were analysed for surface area regression of BE and stricture formation. For those patients who went on to complete RFA treatment histological regression of intestinal metaplasia (EoT (End of Treatment) CR-IM) and dysplasia (EoT CR-D) were analysed.
Results 11 centres across the UK and Ireland submitted 116 patients treated with the Halo 360 Express Catheter. The mean age was 66 years+/-9.8. 83% were male. 38 patients had low grade dysplasia as baseline histology (32.7%); 59 patients had high grade dysplasia (50.8%) and 19 patients had intra-mucosal carcinoma (16.5%). The mean pre-treatment circumferential length of BE (C) was 5.5 cm +/-4.3 cm and the mean maximal length (M) was 7.7 cm +/-3.6 cm. 47% had had previous ER.
80/116 had at least 3 month follow up. In these, the mean% reduction in C was 77.4%+/-36.8% and the mean% reduction in M was 53.2%+/-38.2%.
11/80 (14%) patients developed strictures that required dilation at 3 months. 2/11 had been treated with 12J dose and 2/11 had had previous ER. The median number of dilations required was 2 (IQR 1–3).
19 patients had reached end of treatment biopsies. 16/19 (84%) had achieved CR-D and 16/19 (84%) had achieved CR-IM.
Conclusion Early experience from the UK and Ireland suggest that the new RFA express is effective in reducing the SA of visible BE by 50% after the index treatment. However, the stricture rate appears high. Although the EoT numbers are small disease eradication in patients with BE neoplasia is good following index RFA express application.
Disclosure of Interest None Declared
- Barrett’s Oesophagus
- Oesophageal stricture
- Radiofrequency Ablation