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The Barrx™ radiofrequency ablation system includes a bipolar radiofrequency energy generator designed to precisely control depth and uniformity of tissue ablation in the GI tract.
The Barrx™ flex RFA energy generator provides the flexibility to choose either the Barrx™ 360 RFA balloon catheter or Barrx™ 360 express RFA balloon catheter for larger circumferential treatment areas or a Barrx™ RFA focal catheter for treatment of smaller focal areas.
Conclusion:
The rate of neoplastic progression to high-grade dysplasia and adenocarcinoma is significantly reduced by RFA
RFA therapy should be considered in patients with a confirmed diagnosis of low-grade dysplasia
Authors: Phoa K, van Vilsteren FI, Weusten BM, et al.
Published in: American Medical Association (JAMA) 2014;311:1209-1217.
This quick guide explains which catheters to use for each condition (Barrett's esophagus, GAVE, Radiation proctitis) and the respective ablation/cleaning protocols and energy settings.
The Barrx™ 360 express RFA balloon catheter and the Barrx™ channel RFA endoscopic catheter simulator application is now available on the Apple App Store®.
This educational application offers an interactive experience that provides useful information about procedural steps, handling, and usage of these devices — in a 3D simulated environment.‡ This app is suitable for iPad®, and is free to download and install.
View our webinars and e-learning for esophageal and gastric diseases.
Watch this online webinar on Barrett's esophagus.
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Email: rs.gi-support@medtronic.com
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† Complete eradication occurred in 92.6% of cases.
‡ This app is for simulation purposes only and does not reflect actual use of the device in a clinical setting with actual equipment. It is also not to be used for training purposes but for demonstration only. While every reasonable precaution has been taken in the preparation of this guide, Medtronic assumes no responsibility for errors or omissions, nor for the uses made of the materials contained herein and the decisions based on such use. This document does not contain all of the information necessary for the proper care and treatment of patients. As such, no individual may rely on the information presented herein in forming a comprehensive treatment program or in treating any patient. No warranties are made, expressed or implied, with regard to the contents of this work or to its applicability to specific patients or circumstances. Medtronic shall not be liable for direct, indirect, special, incidental or consequential damages arising out of the use or inability to use the contents of this guide.
* Does not apply to the Barrx™ 360 express RFA balloon catheter
§ 94% is the calculated relative risk reduction [ (26-1.5)/26] = 25/26 *100. From [25.0% (1.5%for ablation vs 26.5%for control; 95%CI, 14.1%-35.9%; P < .001]
1. Phoa KN, et al. Radiofrequency ablation vs. endoscopic surveillance for patients with Barrett’s esophagus and low-grade dysplasia: A randomized clinical trial. JAMA. 2014 Mar 26;311(12):1209–17.
2. Shaheen NJ, Sharma P, Overholt BF, et al. Radiofrequency ablation in Barrett’s esophagus with dysplasia. N Engl J Med 2009;360:2277–88.
3.Phoa KN, Pouw RE, van Vilsteren FG, et al. Remission of Barrett’s esophagus with early neoplasia 5 years after radiofrequency ablation with endoscopic resection: A Netherlands cohort study. Gastroenterology. 2013;145:96–104.
4. Halland.M. Recent developments in pathogenesis, diagnosis and therapy of Barrett's Esophagus. World Journal of Gastroenterology 2015 June 7; 21(21): 6479-6490.
5. Shaheen NJ al. Radiofrequency Ablation in Barrett’s Esophagus with Dysplasia. New England Journal of Medicine. 2009 May;360(22):2277-2288
6. Hathorn et al. Predictors of complications from radiofrequency ablation during treatment of Barrett’s esophagus: results from the U.S. RFA registry. Gastrointestinal Endoscopy 2014;79(5), AB152-153. 2014 DDW Abstracts
7. Whiteman DC, et al. Australian clinical practice guidelines for the diagnosis and management of Barrett's esophagus and early esophageal adenocarcinoma. J Gastroenterol Hepatol 2015; 30: 804-20.
8. Phoa KN. et al. Multimodality endoscopic radication for neoplastic Barrett oesophagus: results of an European multicentre study (EURO-II). Gut 2015; doi 10.1136/gutjnl-2015-309298.
9. Shaheen NJ, Falk GW, Iyer PG, Gerson LB. ACG Clinical guideline: diagnosis and management of Barrett’s esophagus. Am J Gastroenterol. 2015;
10. Fleischer DE, Overholt BF, Sharma VK, et al. Endoscopic ablation of Barrett’s esophagus: a multicenter study with 2.5-year follow-up. Gastrointest Endoscopy. 2008;68:867–876.
11. Weusten Bas et al. ESGE Guidelines. Endoscopic management of Barrett’s esophagus: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2017.