PMID- 19610568
OWN - NLM
STAT- MEDLINE
DCOM- 20090812
LR  - 20121115
IS  - 0004-4849 (Print)
IS  - 0004-4849 (Linking)
VI  - 98
IP  - 4
DP  - 2006 Oct-Dec
TI  - Balloon-based electrode for the ablation of non-dysplastic Barrett's esophagus: 
      ablation of intestinal metaplasia (AIM II Trial).
PG  - 270-5
AB  - INTRODUCTION: Barrett's esophagus (BE) is a condition in which an abnormal 
      intestinal-type epithelium called specialized intestinal metaplasia (SIM) 
      replaces the stratified squamous epithelium that normally lines the distal 
      esophagus. This occurs as a consequence of chronic gastroesophageal reflux 
      disease (GERD) which is present in more than 20% of adults. It is present in 1-2% 
      of the United States population with an estimated prevalence as high as 25% in 
      white males older than 50 yrs without GERD. This intestinal metaplasia 
      predisposes patients to esophageal adenocarcinoma, the most rapidly rising tumor 
      incidence over the last 30 years, with an annual incidence of 0.5% in patients 
      with BE and a survival rate less than 10% in 5 years. The objective of the study 
      was to assess the safety and efficacy of circumferential endoscopic ablation of 
      Barrett's esophagus using the HALO360 System. METHODS: Patients with 
      non-dysplastic Barrett's esophagus confirmed within the previous year were 
      treated twice per session with a balloon-based, bipolar radiofrequency ablation 
      device with a pre selected energy of 10 J/ cm2 at 260 W for 10 secs, achieving 
      full thickness ablation of epithelium followed by Omeprazole 40 mg PO BID for 1 
      month and then, daily. Patients were followed at 1, 3, 6 and 12 months with EGD 
      with biopsy and a 2nd re treatment at 4 month if IM persisted. RESULTS: A total 
      of 21 Hispanic patients underwent treatment with a gender distribution of 9 
      female and 10 male, at a mean age of 59.6 years old (SD +/- 12.9) and a mean 
      weight of 161 Lbs (SD +/- 26.1). There was a complete response of 66.7%, 61.9%, 
      76.2%, 76.2% at 1, 3, 6, and 12 month respectively and a biopsy clearance rate 
      (BCR) of 84.6% and 92.3% at 6 and 12 mo with single treatment and of 62.5% and 
      50.0% at 6 and 12 month in retreated patients. No complications from the 
      procedure such as strictures or ulcers were reported at 1 year after treatment. 
      CONCLUSIONS: In spite of the multiple treatment options for BE, especially among 
      ablation techniques, radiofrequency ablation therapy is achieving promising 
      results with a full thickness ablation of Barrett's epithelium in 76.2% of 
      patients without direct injury to the submucosa, avoiding formation of strictures 
      and minimal side effects from treatment.
FAU - Aviles, Amarilis
AU  - Aviles A
AD  - Ponce Gastroenterology Center & Internal Medicine Residency, Damas Hospital - 
      Ponce School of Medicine Teaching Consortium, Ponce, Puerto Rico.
FAU - Reymunde, Alvaro
AU  - Reymunde A
FAU - Santiago, Nilda
AU  - Santiago N
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - Puerto Rico
TA  - Bol Asoc Med P R
JT  - Boletin de la Asociacion Medica de Puerto Rico
JID - 7505267
SB  - IM
MH  - Barrett Esophagus/*surgery
MH  - Catheter Ablation/*instrumentation
MH  - Catheterization/*instrumentation
MH  - Electrodes
MH  - Equipment Design
MH  - Esophagus/pathology/surgery
MH  - Female
MH  - Humans
MH  - Male
MH  - Metaplasia
MH  - Middle Aged
MH  - Prospective Studies
EDAT- 2006/10/01 00:00
MHDA- 2009/08/13 09:00
CRDT- 2009/07/21 09:00
PHST- 2009/07/21 09:00 [entrez]
PHST- 2006/10/01 00:00 [pubmed]
PHST- 2009/08/13 09:00 [medline]
PST - ppublish
SO  - Bol Asoc Med P R. 2006 Oct-Dec;98(4):270-5.