Management of Barrett’s esophagus with dysplasia refractory to radiofrequency ablation

Figure 1 Endoscopy images of a patient with radiofrequency ablation refractory Barrett’s after multiple sessions of radiofrequency ablation. A: A patient with dysplastic Barrett’s refractory to radiofrequency ablation; B: Who was treated with liquid nitrogen spray cryotherapy; C: Achieved complete eradication of intestinal metaplasia.

Figure 2 A patient from our practice who underwent five radiofrequency ablation sessions, who then underwent salvage CryoBalloon cryotherapy. A: A patient with dysplastic Barrett’s refractory to radiofrequency ablation (note endoscopy image is in narrow band imaging mode); B: Who was treated with CryoBalloon cryotherapy; C: Achieved complete eradication of intestinal metaplasia (note endoscopy image is in narrow band imaging mode).

Figure 3 A patient who underwent multiple sessions of radiofrequency ablation with refractory dysplasia. A: A patient with dysplastic Barrett’s refractory to radiofrequency ablation; B: Who was treated with hybrid argon plasma coagulation; C: Achieved complete eradication of intestinal metaplasia (note endoscopy image is in narrow band imaging mode).

Figure 4 A case of Barrett’s esophagus refractory to multiple sessions of radiofrequency ablation and cryotherapy in long segment Barrett’s. A: A patient with dysplastic Barrett’s refractory to radiofrequency ablation and had a narrowing in the esophagus with residual dysplastic Barrett’s who was treated with the EndoRotor ablation system; B: Achieved complete eradication of intestinal metaplasia (note endoscopy image is in narrow band imaging mode).

Figure 5 Proposed algorithm for management of Barrett’s refractory to radiofrequency ablation. RFA: Radiofrequency ablation; BE: Barrett’s esophagus; APC: Argon plasma coagulation.