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Aims Cryoballoon Focal Ablation (CbFA; C2 Merit Medical) is a well-tolerated and effective endoscopic eradication therapy (EET) for Barrett’s esophagus (BE) with early neoplasia. Prior experience has largely been limited to BE segments of ≤C2M5, with few long-term durability data, and earlier studies using a 10-second (s) dose per ablation. We report outcomes from a prospective UK multicentre registry using a refined approach of 8s per ablation with adjunct mucosal protective medication and including longer BE segments.Methods The study methodology is outlined in figure 1. Consecutive patients from three UK tertiary centres were prospectively enrolled. Inclusion criteria were BE ≤C5M5 with an indication for ablation therapy, such as BE with early neoplasia (BE-D: low-grade dysplasia (LGD), high-grade dysplasia (HGD), intramucosal adenocarcinoma) without a visible lesion or residual BE following endoscopic resection of early neoplasia. CbFA was repeated at 3-monthly intervals until eradication or a maximum of five sessions, using a focal catheter with an 8s dose per application. In between each treatment, patients received high-dose proton pump inhibitor twice daily and 14 days of sucralfate (2 g, three times daily). Adjunct argon plasma coagulation (APC) was permitted after two CbFA sessions for residual islands <5 mm. Post treatment surveillance and biopsies followed ESGE guidance. Primary endpoints were histologically confirmed eradication of intestinal metaplasia (CE-IM), and dysplasia (CE-D) at the end of treatment. Secondary outcomes included number of ablation sessions, adverse events, device malfunction, and stricture rate.Results From January 2020 to November 2025, 67 patients were recruited (80.6% male; mean age 71), and underwent 138 CbFA sessions. Median pre-ablation BE length was C0M2 (maximum C5M5). Worst baseline histology was LGD in 41.8%, HGD in 31.3%, early cancer in 19.4%, and intestinal metaplasia in 7.5% (including RFA-refractory). Most patients (92.5%) were ablation treatment-naïve; 7.5% had RFA-refractory BE. Among treatment-naïve patients, 43 underwent prior endoscopic resection (39 EMR, 4 ESD).In those patients completing CbFA treatment to date (n=22), CE-D was achieved in 100% and CE-IM 90.9%, after a median of two CbFA sessions, with 31.8% receiving adjunct APC. No device malfunctions or intraprocedural adverse events occurred. Strictures developed in 9% and resolved with balloon dilatation. Durability data were available for 10 patients (mean follow-up 31.3 months, range 14.2–53.2), with CE-D 100% and CE-IM 90.0%.Conclusions Interim real-world registry results, including medium-term durability, align with the larger Euro-Coldplay study, supporting CbFA as a safe and effective EET option for BE-D in segments up to ≤C5M5, with a lower stricture rate using our refinement approach. Ongoing enrolment will further define long-term efficacy and safety in routine UK practice.Abstract P30 Figure 1Registry treatment algorithm. BE = Barrett’s oesophagus; FCBA = cryoballoon focal ablation; LGD = low-grade dysplasia; HGD = high-grade dysplasia; IMC = intramucosal adenocarcinoma; NEO-SCJ = neo-squamocolumnar junction; PPI = proton pump inhibitor; H2RA = histamine H2-receptor antagonist