Compared to surveillance, proactive treatment with radiofrequency ablation can lead to significantly improved outcomes for patients with Barrett’s esophagus (BE), including:
Up to 94%* reduction in the relative risk of disease progression to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC).1
RFA can reduce absolute risk of progression from confirmed LGD to HGD/EAC by 25% compared to surveillance (NNT=4).1
Up to a 10-fold reduction in the risk of progression to EAC in patients with non-dysplastic BE compared to surveillance.2
Clinical studies have demonstrated the safety and efficacy of RFA for treating all grades of Barrett's esophagus.2, 3, 4, 5
The purpose of surveillance in BE is the early detection of dysplasia. While difficult to predict which patients will progress, we do know several factors put a patient at greater risk for intermediate dysplasia, and high risk for HGD or EAC.6
Nondysplastic Barrett's esophagus
Endoscopic ablation therapy has proved to be more effective than surveillance.1 Radiofrequency ablation (RFA) has been shown to be a good option for the treatment of patients with LGD and HGD with low rate of complications and good cost-effective results.9
Moreover, the use of RFA for the treatment of patients with confirmed LGD has shown a significant reduction in progression to HGD and EAC in one randomized trial.1
The proprietary technology in Barrx™ radiofrequency ablation systems is designed to remove the Barrett’s epithelium without significant injury to the underlying tissue.10
Major GI societies, ACG9, AGA11, and ASGE12 support the use of radiofrequency ablation in the treatment guidelines for dysplastic Barrett's esophagus. The AGA11 also supports RFA in non-dysplastic Barrett's esophagus patients, who are at increased risk for EAC or HGD.
The Barrx™ radiofrequency ablation system includes the Barrx™ flex RFA energy generator and a family of ablation catheters which are designed to precisely control depth and uniformity of GI tissue ablation. 9
Talk to a Medtronic sales representative about how the Barrx™ radiofrequency ablation system can safely eliminate Barrett’s esophagus and help reduce risk for patients who may be intermediate and at high risk for progression to HGD or EAC.1,5,10
We’re excited to share our online patient resource, designed for chronic reflux and Barrett’s esophagus patients to learn more about reflux diseases, plus related diagnostic and therapeutic procedures. Explore our collection of patient stories and resources.
Barrx™ radiofrequency ablation system
The following are transient side effects that may be expected after treatment: chest pain, difficulty swallowing, painful swallowing, throat pain, and/or fever. Potential complications include mucosal laceration, minor or major bleeding, endoscopic clipping to manage mucosal laceration or bleeding, perforation of the stomach, esophagus or pharynx, surgery to manage perforation, esophageal stricture, endoscopic dilation to manage stricture, pleural effusion, transfusion secondary to major bleeding, cardiac arrhythmia, aspiration, infection, and death.
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]
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.
Wolf WA, Lightdale CJ, Li N, et al. Incidence of Esophageal Adenocarcinoma (EAC) in Patients with Barrett’s Esophagus (BE) Undergoing Radiofrequency Ablation. Gastroenterology. 2015 Aug 28. (15)1245–7.
Shaheen NJ, Sharma P, Overholt BF, et al. Radiofrequency ablation in Barrett’s esophagus with dysplasia. N Engl J Med 2009;360:2277–88.
Wolf WA, Pasricha S, Cotton C, et al. Incidence of esophageal adenocarcinoma and causes of mortality after radiofrequency ablation of Barrett’s esophagus. Gastroenterology. 2015;149:1752–1761.
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.
Brown CS, Lapin B, Goldstein JL, et al. Predicting Progression in Barrett’s Esophagus: Development and Validation of the Barrett’s Esophagus Assessment of Risk Score (BEAR Score). Annals of Surgery. 2018;267(4):716–720.
Tofani C, et al. Abstract 69. Presented at: World Congress of Gastroenterology at American College of Gastroenterology Annual Scientific Meeting; Oct. 13–18, 2017; Orlando, FL.
Anaparthy R, Gaddam S, Kanakadandi V, et al. Association between length of Barrett’s esophagus and risk of high-grade dysplasia or adenocarcinoma in patients without dysplasia. Clin Gastroenterol Hepatol. 2013;11(11):1430–6.
Shaheen NJ, Falk GW, Iyer PG, Gerson LB. ACG Clinical guideline: diagnosis and management of Barrett’s esophagus. Am J Gastroenterol. 2015;
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.
Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ. American Gastroenterological Association. American Gastroenterological Association medical position statement on the management of Barrett’s esophagus. Gastroenterology. 2011;140:1084–1091.
Wani S, Qumseya B, et al. ASGE Standards of Practice Committee. Endoscopic eradication therapy for patients with Barrett’s esophagus-associated dysplasia and intramucosal cancer. Gastrointestinal Endoscopy. 2018. Volume 87, No. 4. 907–931.