Treatment experience with a novel 30-mm hydrostatic balloon in esophageal dysmotility: a multicenter retrospective analysis

Joshua A. Sloan; Joseph R. Triggs; John E. Pandolfino; Mohamad Dbouk; Olaya I. Brewer Gutierrez; Mohamad El Zein; Farhan Quader; Yervant Ichkhanian; C. Prakash Gyawali; Joel H. Rubenstein; Mouen A. Khashab

doi:10.1016/j.gie.2020.04.076

Treatment experience with a novel 30-mm hydrostatic balloon in esophageal dysmotility: a multicenter retrospective analysis

Joshua A. Sloan, Joseph R. Triggs, John E. Pandolfino, Mohamad Dbouk, Olaya I. Brewer Gutierrez, Mohamad El Zein, Farhan Quader, Yervant Ichkhanian, C. Prakash Gyawali, Joel H. Rubenstein, Mouen A. Khashab

Research output: Contribution to journal › Article › peer-review

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Abstract

Background and Aims: The newest addition in the management of achalasia and esophagogastric junction outflow obstruction (EGJOO) is a 30-mm hydrostatic balloon dilator that uses impedance planimetry technology. It allows for the measurement of the diameter and cross-sectional area to determine effective dilation. We aimed to (1) determine the clinical success (defined as a decrease in Eckardt score to ≤3) in the treatment of esophageal motility disorders and (2) report the safety (rate/severity of adverse events). Methods: This retrospective multicenter study involved 4 centers. Patients with esophageal motility disorders who underwent hydrostatic balloon dilation between January 2015 and October 2018 were included. Results: Fifty-one patients (mean age, 54.1 years; women, 49%) underwent hydrostatic dilation for achalasia (n = 37) or EGJOO (n = 14) during the study period. Forty-seven patients had a median baseline Eckardt score of 5 (range, 3-8; achalasia, n = 35, 6 [range, 3-8]; EGJOO, n = 12, 4 [range, 3.25-6.5]). Clinical success was achieved in 60% of cases (achalasia vs EGJOO: 68.4% vs 33.3%, P = .18). Dilation resulted in a significant decrease in the median Eckardt score from 5 (range, 3-8) to 1.5 (range, 1-4.75; P < .001). Patients with achalasia had a decrease in Eckardt score from 6 (range, 3-8) to 1 (range, 1-4; P < .001), whereas those with EGJOO experienced no significant change. One patient had mild postprocedure chest pain. Conclusions: The hydrostatic balloon dilator is a new tool in our armamentarium to treat esophageal motility disorders. This is the first multicenter study showing the device to be safe and moderately efficacious.

Original language	English (US)
Pages (from-to)	1251-1257
Number of pages	7
Journal	Gastrointestinal endoscopy
Volume	92
Issue number	6
DOIs	https://doi.org/10.1016/j.gie.2020.04.076
State	Published - Dec 2020
Externally published	Yes

Bibliographical note

Funding Information:
DISCLOSURE: The following authors disclosed financial relationships: J. E. Pandolfino: Ownership interest in Crospon and Medtronic; consultant for Medtronic, Sandhill Scientific, and Torax; speaker for Astra Zeneca; scientific consultant for Ironwood and Diversatek; legal consultant for Takeda, grant recipient from Impleo. C. P. Gyawali: Consultant for Medtronic, Diversatek, Ironwood, Quintiles, and Isothrive. M. A. Khashab: Consultant for BSCI, Medtronic, and Olympus. All other authors disclosed no financial relationships.

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© 2020 American Society for Gastrointestinal Endoscopy

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Sloan, J. A., Triggs, J. R., Pandolfino, J. E., Dbouk, M., Brewer Gutierrez, O. I., El Zein, M., Quader, F., Ichkhanian, Y., Gyawali, C. P., Rubenstein, J. H., & Khashab, M. A. (2020). Treatment experience with a novel 30-mm hydrostatic balloon in esophageal dysmotility: a multicenter retrospective analysis. Gastrointestinal endoscopy, 92(6), 1251-1257. https://doi.org/10.1016/j.gie.2020.04.076

Sloan, JA, Triggs, JR, Pandolfino, JE, Dbouk, M, Brewer Gutierrez, OI, El Zein, M, Quader, F, Ichkhanian, Y, Gyawali, CP, Rubenstein, JH & Khashab, MA 2020, 'Treatment experience with a novel 30-mm hydrostatic balloon in esophageal dysmotility: a multicenter retrospective analysis', Gastrointestinal endoscopy, vol. 92, no. 6, pp. 1251-1257. https://doi.org/10.1016/j.gie.2020.04.076

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abstract = "Background and Aims: The newest addition in the management of achalasia and esophagogastric junction outflow obstruction (EGJOO) is a 30-mm hydrostatic balloon dilator that uses impedance planimetry technology. It allows for the measurement of the diameter and cross-sectional area to determine effective dilation. We aimed to (1) determine the clinical success (defined as a decrease in Eckardt score to ≤3) in the treatment of esophageal motility disorders and (2) report the safety (rate/severity of adverse events). Methods: This retrospective multicenter study involved 4 centers. Patients with esophageal motility disorders who underwent hydrostatic balloon dilation between January 2015 and October 2018 were included. Results: Fifty-one patients (mean age, 54.1 years; women, 49%) underwent hydrostatic dilation for achalasia (n = 37) or EGJOO (n = 14) during the study period. Forty-seven patients had a median baseline Eckardt score of 5 (range, 3-8; achalasia, n = 35, 6 [range, 3-8]; EGJOO, n = 12, 4 [range, 3.25-6.5]). Clinical success was achieved in 60% of cases (achalasia vs EGJOO: 68.4% vs 33.3%, P = .18). Dilation resulted in a significant decrease in the median Eckardt score from 5 (range, 3-8) to 1.5 (range, 1-4.75; P < .001). Patients with achalasia had a decrease in Eckardt score from 6 (range, 3-8) to 1 (range, 1-4; P < .001), whereas those with EGJOO experienced no significant change. One patient had mild postprocedure chest pain. Conclusions: The hydrostatic balloon dilator is a new tool in our armamentarium to treat esophageal motility disorders. This is the first multicenter study showing the device to be safe and moderately efficacious.",

author = "Sloan, {Joshua A.} and Triggs, {Joseph R.} and Pandolfino, {John E.} and Mohamad Dbouk and {Brewer Gutierrez}, {Olaya I.} and {El Zein}, Mohamad and Farhan Quader and Yervant Ichkhanian and Gyawali, {C. Prakash} and Rubenstein, {Joel H.} and Khashab, {Mouen A.}",

note = "Funding Information: DISCLOSURE: The following authors disclosed financial relationships: J. E. Pandolfino: Ownership interest in Crospon and Medtronic; consultant for Medtronic, Sandhill Scientific, and Torax; speaker for Astra Zeneca; scientific consultant for Ironwood and Diversatek; legal consultant for Takeda, grant recipient from Impleo. C. P. Gyawali: Consultant for Medtronic, Diversatek, Ironwood, Quintiles, and Isothrive. M. A. Khashab: Consultant for BSCI, Medtronic, and Olympus. All other authors disclosed no financial relationships. Publisher Copyright: {\textcopyright} 2020 American Society for Gastrointestinal Endoscopy",

year = "2020",

month = dec,

doi = "10.1016/j.gie.2020.04.076",

language = "English (US)",

volume = "92",

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T1 - Treatment experience with a novel 30-mm hydrostatic balloon in esophageal dysmotility

T2 - a multicenter retrospective analysis

AU - Sloan, Joshua A.

AU - Triggs, Joseph R.

AU - Pandolfino, John E.

AU - Dbouk, Mohamad

AU - Brewer Gutierrez, Olaya I.

AU - El Zein, Mohamad

AU - Quader, Farhan

AU - Ichkhanian, Yervant

AU - Gyawali, C. Prakash

AU - Rubenstein, Joel H.

AU - Khashab, Mouen A.

N1 - Funding Information: DISCLOSURE: The following authors disclosed financial relationships: J. E. Pandolfino: Ownership interest in Crospon and Medtronic; consultant for Medtronic, Sandhill Scientific, and Torax; speaker for Astra Zeneca; scientific consultant for Ironwood and Diversatek; legal consultant for Takeda, grant recipient from Impleo. C. P. Gyawali: Consultant for Medtronic, Diversatek, Ironwood, Quintiles, and Isothrive. M. A. Khashab: Consultant for BSCI, Medtronic, and Olympus. All other authors disclosed no financial relationships. Publisher Copyright: © 2020 American Society for Gastrointestinal Endoscopy

PY - 2020/12

Y1 - 2020/12

N2 - Background and Aims: The newest addition in the management of achalasia and esophagogastric junction outflow obstruction (EGJOO) is a 30-mm hydrostatic balloon dilator that uses impedance planimetry technology. It allows for the measurement of the diameter and cross-sectional area to determine effective dilation. We aimed to (1) determine the clinical success (defined as a decrease in Eckardt score to ≤3) in the treatment of esophageal motility disorders and (2) report the safety (rate/severity of adverse events). Methods: This retrospective multicenter study involved 4 centers. Patients with esophageal motility disorders who underwent hydrostatic balloon dilation between January 2015 and October 2018 were included. Results: Fifty-one patients (mean age, 54.1 years; women, 49%) underwent hydrostatic dilation for achalasia (n = 37) or EGJOO (n = 14) during the study period. Forty-seven patients had a median baseline Eckardt score of 5 (range, 3-8; achalasia, n = 35, 6 [range, 3-8]; EGJOO, n = 12, 4 [range, 3.25-6.5]). Clinical success was achieved in 60% of cases (achalasia vs EGJOO: 68.4% vs 33.3%, P = .18). Dilation resulted in a significant decrease in the median Eckardt score from 5 (range, 3-8) to 1.5 (range, 1-4.75; P < .001). Patients with achalasia had a decrease in Eckardt score from 6 (range, 3-8) to 1 (range, 1-4; P < .001), whereas those with EGJOO experienced no significant change. One patient had mild postprocedure chest pain. Conclusions: The hydrostatic balloon dilator is a new tool in our armamentarium to treat esophageal motility disorders. This is the first multicenter study showing the device to be safe and moderately efficacious.

AB - Background and Aims: The newest addition in the management of achalasia and esophagogastric junction outflow obstruction (EGJOO) is a 30-mm hydrostatic balloon dilator that uses impedance planimetry technology. It allows for the measurement of the diameter and cross-sectional area to determine effective dilation. We aimed to (1) determine the clinical success (defined as a decrease in Eckardt score to ≤3) in the treatment of esophageal motility disorders and (2) report the safety (rate/severity of adverse events). Methods: This retrospective multicenter study involved 4 centers. Patients with esophageal motility disorders who underwent hydrostatic balloon dilation between January 2015 and October 2018 were included. Results: Fifty-one patients (mean age, 54.1 years; women, 49%) underwent hydrostatic dilation for achalasia (n = 37) or EGJOO (n = 14) during the study period. Forty-seven patients had a median baseline Eckardt score of 5 (range, 3-8; achalasia, n = 35, 6 [range, 3-8]; EGJOO, n = 12, 4 [range, 3.25-6.5]). Clinical success was achieved in 60% of cases (achalasia vs EGJOO: 68.4% vs 33.3%, P = .18). Dilation resulted in a significant decrease in the median Eckardt score from 5 (range, 3-8) to 1.5 (range, 1-4.75; P < .001). Patients with achalasia had a decrease in Eckardt score from 6 (range, 3-8) to 1 (range, 1-4; P < .001), whereas those with EGJOO experienced no significant change. One patient had mild postprocedure chest pain. Conclusions: The hydrostatic balloon dilator is a new tool in our armamentarium to treat esophageal motility disorders. This is the first multicenter study showing the device to be safe and moderately efficacious.

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Treatment experience with a novel 30-mm hydrostatic balloon in esophageal dysmotility: a multicenter retrospective analysis

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