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Halo ablation of barrett's esophagus

Cary C Cotton, Rehan Haidry, Aaron P Thrift, Laurence Lovat, Nicholas J Shaheen
BACKGROUND & AIMS: Barrett's esophagus (BE) recurs in 25% or more of patients treated successfully with radiofrequency ablation (RFA), so surveillance endoscopy is recommended after complete eradication of intestinal metaplasia (CEIM). The frequency of surveillance is informed only by expert opinion. We aimed to model the incidence of neoplastic recurrence, validate the model in an independent cohort, and propose evidence-based surveillance intervals. METHODS: We collected data from the United States Radiofrequency Ablation Registry (US RFA, 2004-2013) and the United Kingdom National Halo Registry (UK NHR, 2007-2015) to build and validate models to predict the incidence of neoplasia recurrence after initially successful RFA...
August 2018: Gastroenterology
Ognjan Skrobić, Aleksandar Simić, Nebojša Radovanović, Nenad Ivanović, Marjan Micev, Predrag Peško
OBJECTIVE: HALO radiofrequency ablation (RFA) has been proven as safe and efficient in eradication of both non- and dysplastic Barrett's esophagus (BE). Definitive post-RFA treatment is yet to be determined. METHODS: RFA was performed in 56 patients with BE, 38 with intestinal metaplasia (IM) and 18 with low-grade dysplasia (LGD), and repeated in case of residual BE. Length of the BE was classified according to C&M criteria. Follow-up included regular upper GI endoscopies with biopsies 6 months, 1 and 2 years after the complete resolution of BE...
September 2016: Surgical Endoscopy
Darina Kohoutova, Rehan Haidry, Matthew Banks, Stephen Bown, Vinay Sehgal, Mohammed Adil Butt, David Graham, Sally Thorpe, Marco Novelli, Manuel Rodriguez-Justo, Laurence Lovat
OBJECTIVE: Photodynamic therapy (PDT) and radiofrequency ablation (RFA) are effective non-surgical options for the treatment of Barrett's esophagus (BE) associated neoplasia. Development of subsquamous intestinal metaplasia after successful PDT and/or RFA is a recognized phenomenon; however, the occurrence of neoplasia arising from buried glands is a rare complication. METHODS: This is a prospective case series of patients treated with PDT and/or RFA from 1999 to 2014 at University College London Hospital for neoplasia associated with BE, whose outcomes were analyzed retrospectively...
2015: Scandinavian Journal of Gastroenterology
F Pigò, H Bertani, M Manno, V G Mirante, A Caruso, R L Conigliaro
BACKGROUND: Chronic radiation proctitis (CRP) occurs up to 20 % of patients after pelvic radiotherapy, with rectal bleeding as the main presenting complaint. Radiofrequency ablation (RFA) has recently been used in the management of Barrett's esophagus, but its efficacy in CRP has to be studied. The aim of this case series was to describe four cases of patients with CRP treated with RFA that demonstrate the efficacy and safety of the technique. METHODS: All the procedures were performed with HALO 90 or HALO 90 Ultra ablation catheter fitted on the distal end of a standard flexible endoscope...
November 2014: Techniques in Coloproctology
Atilla Ertan, Irum Zaheer, Arlene M Correa, Nirav Thosani, Shanda H Blackmon
AIM: To compare effectiveness, safety, and cost of photodynamic therapy (PDT) and radiofrequency ablation (RFA) in treatment of Barrett's dysplasia (BD). METHODS: Consecutive case series of patients undergoing either PDT or RFA treatment at single center by a single investigator were compared. Thirty-three patients with high-grade dysplasia (HGD) had treatment with porfimer sodium photosensitzer and 630 nm laser (130 J/cm), with maximum of 3 treatment sessions. Fifty-three patients with BD (47 with low-grade dysplasia -LGD, 6 with HGD) had step-wise circumferential and focal ablation using the HALO system with maximum of 4 treatment sessions...
November 7, 2013: World Journal of Gastroenterology: WJG
Wojciech P Dąbrowski, Andrzej B Szczepanik, Andrzej Misiak, Konrad Pielaciński
INTRODUCTION: Barrett's esophagus develops as a result of chronic injury of esophagus epithelium from gastroesophageal reflux disease. It is defined when metaplastic columnar epithelium replaces the stratified squamous epithelium which normally lies in the distal esophagus. The condition represents a risk factor for esophageal adenocarcinoma. The aim of the radiofrequency ablation (RFA) method is to destroy metaplastic epithelium with radiofrequency electric current and to stimulate reappearance of the flat multilayer epithelium in the distal esophagus...
June 2013: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Min P Kim, Kendra N Brown, Mary R Schwartz, Shanda H Blackmon
OBJECTIVE: We sought to evaluate clinicopathologic features of patients who underwent esophageal surgery after radiofrequency ablation (RFA) treatment using the HALO system for Barrett esophagus (BE) with high-grade dysplasia (HGD). METHODS: We evaluated patients from our hospital database who underwent esophagectomy from August 2006 to January 2012 after previously receiving RFA for BE. Information on demographics, time between RFA and surgery, indications for surgery, and final esophageal pathology was collected...
January 2013: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Rehan J Haidry, Jason M Dunn, Mohammed A Butt, Matthew G Burnell, Abhinav Gupta, Sarah Green, Haroon Miah, Howard L Smart, Pradeep Bhandari, Lesley Ann Smith, Robert Willert, Grant Fullarton, John Morris, Massimo Di Pietro, Charles Gordon, Ian Penman, Hugh Barr, Praful Patel, Philip Boger, Neel Kapoor, Brinder Mahon, Jonathon Hoare, Ravi Narayanasamy, Dermot O'Toole, Edward Cheong, Natalie C Direkze, Yeng Ang, Marco Novelli, Matthew R Banks, Laurence Bruce Lovat
BACKGROUND & AIMS: Patients with Barrett's esophagus (BE) and high-grade dysplasia (HGD) or early neoplasia increasingly receive endoscopic mucosal resection and radiofrequency ablation (RFA) therapy. We analyzed data from a UK registry that follows the outcomes of patients with BE who have undergone RFA for neoplasia. METHODS: We collected data on 335 patients with BE and neoplasia (72% with HGD, 24% with intramucosal cancer, 4% with low-grade dysplasia [mean age, 69 years; 81% male]), treated at 19 centers in the United Kingdom from July 2008 through August 2012...
July 2013: Gastroenterology
N Villa, H B El-Serag, M Younes, A Ertan
Radiofrequency ablation (RFA) with HALO system has been developed as a new treatment option for Barrett's esophagus (BE). It had been observed that some patients had esophageal eosinophilia (EE) infiltration after RFA. The incidence and features of EE after RFA were systematically determined. From a prospectively compiled database, data on 148 patients who underwent RFA for BE were analyzed. Biopsies were taken pre- and post-RFA from the BE segment, and histological sections of the biopsy specimens were stained with hematoxylin and eosin, and examined by a gastrointestinal pathologist...
September 2013: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
David S Wolf, Brian J Dunkin, Atilla Ertan
Recently, extensive data have been published about the safety and efficacy of endoscopic radiofrequency ablation (RFA) of Barrett's esophagus (BE) with early cancer and dysplasia as well as without dysplasia. RFA has been shown to be effective and safe. Circumferential RFA is delivered using the HALO(360+) Ablation System (Covidien, Inc., Mansfield, MA), which consists ofa high-power energy generator, a sizing balloon catheter, and a number of balloon-based ablation catheters with varying outer diameters. Focal RF energy is delivered using the HALO(90) or HALO(60) Ablation Systems (Covidien, Inc...
December 2012: Surgical Technology International
Aleksandar Simić, Ognjan Skrobić, Marijan Micev, Mirko Gligorijević, Dejan Velicković, Nenad Ivanović, Predrag Pesko
INTRODUCTION: Barrett's esophagus (BE) is a well established precursor of esophageal adenocarcinoma. Both, surveillance and therapeutic strategies have been proposed over the years. Recent deve-lopment of endoscopic radiofrequency ablation (RFA) brought new perspectives in the treatment of BE, with excellent initial results. METHODS: The study of 40 pts with macroscopically visible BE on endoscopy and biopsy proven goblet cells presence, was conducted from January 2010 until March 2012...
2012: Acta Chirurgica Iugoslavica
F Caillol, E Bories, C Pesenti, F Poizat, G Monges, J Guiramand, B Esterni, M Giovannini
UNLABELLED: Endoscopic resection (EMR) and radiofrequency ablation (RFA) form part of the treatment of Barrett's oesophagus (BO), dysplasia, superficial adenocarcinoma (OAC) associated with BO. PATIENTS AND METHODS: Between June 2008 and April 2011, 34 patients underwent treatment with RFA (HALO system(®)), in a tertiary centre. For the study, patients were divided into two groups. Group 1 (16 patients of average 60 years old; 14 men, two women) received EMR and RFA...
August 2012: Clinics and Research in Hepatology and Gastroenterology
Chatura S Jayasekera, Finlay A Macrae, Paul V Desmond, Andrew C F Taylor
No abstract text is available yet for this article.
March 7, 2011: Medical Journal of Australia
Mehrdad Nikfarjam, Ashley Faulx, Michelle Laughinghouse, Jeffrey M Marks
BACKGROUND: Chronic radiation proctitis can be difficult to manage. Radiofrequency ablation has recently been shown to be effective in the management of gastric antral vascular ectasia and Barrett's esophagus, but its utility in the treatment of chronic radiation proctitis is undetermined. METHOD: A 77-year-old man with extensive chronic radiation proctitis had continued bleeding despite argon plasma coagulation. The HALO(90) radiofrequency system (BARRX Medical, Sunnyvale, CA) was used for treatment regions of proctitis at an energy density of 12 J/cm(2)...
June 2010: Surgical Innovation
Thomas Semlitsch, Klaus Jeitler, Rainer Schoefl, Karl Horvath, Nicole Pignitter, Franz Harnoncourt, Andrea Siebenhofer
BACKGROUND: Radiofrequency ablation with the HALO system is a new option for the treatment of patients with Barrett's esophagus. This systematic review summarizes the results of all relevant publications on this topic to answer patient-relevant clinical questions and to evaluate the potential benefit and harm of this new therapy. METHODS: A systematic literature search of MEDLINE and CENTRAL up to May 2009 was performed. To identify the relevant literature, references were evaluated by two reviewers independently...
December 2010: Surgical Endoscopy
Ricardo S dos Santos, Costas Bizekis, Michael Ebright, Michael DeSimone, Benedict D Daly, Hiran C Fernando
OBJECTIVE: Radiofrequency ablation for Barrett's esophagus in combination with an antireflux procedure has not been widely documented. We report our initial experience with radiofrequency ablation in association with antireflux procedure for Barrett's metaplasia and low-grade dysplasia. METHODS: A total of 14 patients (10 male and 4 female patients) presented with Barrett's metaplasia (n=11) or low-grade dysplasia (n=3). Median age was 60 years (38-80 years). The severity of Barrett's esophagus was classified by length (in centimeters), appearance (circumferential/noncircumferential), and histology (1, normal; 2, Barrett's metaplasia; and 3, low-grade dysplasia)...
March 2010: Journal of Thoracic and Cardiovascular Surgery
David E Fleischer, Virender K Sharma
There is increasing interest in the endoscopic treatment of Barrett's esophagus. Endoscopic treatment has been utilized for many years, but in the past, no specific method has emerged as an appealing treatment option with appropriate safety, efficacy and ease of treatment for both patients and physicians. Recently there has been a growing literature related to the endoscopic ablation of Barrett's esophagus using radiofrequency ablation (RFA) (Halo system). In order to discuss when RFA is indicated for Barrett's, one needs to know: (1) What is the 'histology' of the Barrett's? Does the patient have intestinal metaplasia, low-grade dysplasia, high-grade dysplasia or intramucosal carcinoma? (2) What are the endoscopic options to be considered as opposed to RFA? What are the advantages and disadvantages of each? (3) What additional variables need to be examined?...
2008: Digestive Diseases
Virender K Sharma, H Jae Kim, Ananya Das, Christopher D Wells, Cuong C Nguyen, David E Fleischer
OBJECTIVES: Dysplasia in a Barrett's esophagus (BE) is associated with an increased risk for developing esophageal adenocarcinoma. Ablation using the HALO system has shown promise for the treatment of BE with dysplasia. The objective of this study was to assess the safety and efficacy of a stepwise regimen of circumferential and focal ablation using the HALO system for the treatment of BE with dysplasia. METHODS: BE patients with low-grade dysplasia (LGD) or high-grade dysplasia (HGD) were enrolled...
February 2009: American Journal of Gastroenterology
R E Pouw, V K Sharma, J J Bergman, D E Fleischer
Stepwise circumferential and focal radiofrequency ablation using the HALO system is a novel and promising ablative modality for Barrett's esophagus. Primary circumferential ablation is performed using a balloon-based bipolar electrode, while secondary treatment of residual Barrett's epithelium is performed using an endoscope-mounted bipolar electrode on an articulated platform. It has been used as a single-modality treatment or in combination with other therapies. Recent studies suggest that this ablation technique is highly effective in removing Barrett's mucosa and its associated dysplasia without the known drawbacks of photodynamic therapy or argon plasma coagulation, such as esophageal stenosis and subsquamous foci of intestinal metaplasia (also known as "buried Barrett")...
December 2008: Endoscopy
Roos E Pouw, Joep J Gondrie, Wouter L Curvers, Carine M Sondermeijer, Fiebo J Ten Kate, Jacques J Bergman
BACKGROUND: For selected patients with high-grade dysplasia (HGD) and/or early esophageal squamous cell cancer (ESCC), endoscopic therapy represents a nonsurgical treatment option. For widespread lesions, however, current endoscopic treatment modalities (eg, endoscopic resection, argon plasma coagulation, photodynamic therapy) are associated with considerable drawbacks, of which esophageal stricturing is the most significant. Balloon-based radiofrequency (RF) ablation (HALO System) is a promising technology for endoscopic treatment of Barrett's esophagus, and may also play a role in treating widespread HGD and early ESCC...
September 2008: Gastrointestinal Endoscopy
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