Dubrouskaya Katsiaryna, Hagenstein Lauren, Ramai Daryl, Adler Douglas G
Rocky Vista University College of Osteopathic Medicine, Ivins, Utah (Katsiaryna Dubrouskaya, Lauren Hagenstein).
University of Utah School of Medicine, Salt Lake City, Utah (Daryl Ramai).
Ann Gastroenterol. 2022 Jul-Aug;35(4):345-350. doi: 10.20524/aog.2022.0721. Epub 2022 Jun 2.
The Barrx™ radiofrequency ablation (RFA) catheter system comes in several different variations and sizes and is widely used for the eradication of Barrett's esophagus (BE). The Barrx™ 360 and 360 Express system is used to perform circumferential RFA, while the Barrx™ focal catheter system is used for secondary focal RFA or primary treatment of short-segment BE. We aimed to investigate the number and type of complications and device failures associated with the Barrx™ RFA catheter system.
We analyzed post-marketing surveillance data from the Food and Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database from August 2011 to August 2021.
During the study period, 148 unique reports detailing 78 device issues and 87 patient-related adverse events were identified. The most reported adverse events for patients were stenosis secondary to treatment (n=15, 17.24%), mucosal laceration of the esophagus (n=13, 14.94%), chest pain (n=10, 11.49%), and odynophagia/dysphagia (n=7, 8.05%). The most common device complication was failure of the device to deploy when activated (n=10, 13.82%). Other device malfunctions included material deformation/distortion (n=7, 8.97%), catheter breakage (n=6, 7.69%), connection problems between the generator cable and RFA device (n=6, 7.69%), and failure of the balloon to properly inflate (n=5, 6.41%).
Findings from the MAUDE database highlight patient and device complications that endoscopists should be aware of prior to RFA of BE with the Barrx™ RFA catheter system.
Barrx™ 射频消融(RFA)导管系统有几种不同的变体和尺寸,广泛用于巴雷特食管(BE)的根除治疗。Barrx™ 360和360 Express系统用于进行环形RFA,而Barrx™ 聚焦导管系统用于短节段BE的二次聚焦RFA或初次治疗。我们旨在调查与Barrx™ RFA导管系统相关的并发症数量和类型以及设备故障情况。
我们分析了美国食品药品监督管理局制造商和用户设施设备经验(MAUDE)数据库2011年8月至2021年8月的上市后监测数据。
在研究期间,共识别出148份详细报告,其中包括78起设备问题和87起与患者相关的不良事件。患者报告最多的不良事件是治疗后继发狭窄(n = 15,17.24%)、食管黏膜撕裂(n = 13,14.94%)、胸痛(n = 10,11.49%)和吞咽痛/吞咽困难(n = 7,8.05%)。最常见的设备并发症是激活时设备无法展开(n = 10,13.82%)。其他设备故障包括材料变形/扭曲(n = 7,8.97%)、导管断裂(n = 6,7.69%)、发生器电缆与RFA设备之间的连接问题(n = 6,7.69%)以及球囊无法正确充气(n = 5,6.41%)。
MAUDE数据库的研究结果突出了内镜医师在使用Barrx™ RFA导管系统对BE进行RFA之前应了解的患者和设备并发症情况。