Preliminary clinical experience with the new cre™ multidiameter balloon for dilatation of esophageal strictures

A. R. Kruse, J. A. Goldstein, J. S. Barkin

Research output: Contribution to journalArticle

Abstract

The new multidiameter Controlled Radial Expansion (CRE™) Balloon, (Microvasive, Boston Scientific Corp., Natick, MA) expands to 3 distinct increasing diameters by progressively increasing its hydrostatic pressure from 3 to 5 to 7 atm using the Alliance inflation device. Linear correlation has been observed between the 3 balloon diameters and the increasing hydrostatic pressure. The purpose of this study was to report preliminary, clinical results using the CRE™ balloon for dilation of esophageal strictures. Methods: Twelve patients with benign esophageal strictures underwent CRE™ balloon dilatation. The stenoses varied from 5 to 13 mm in diameter (median 11 mm). Dysphagia was graded on a 0-5 scale (5 being normal with the group median score of 3 (range 1-4). The patients underwent endoscopy using Olympus GIF-IT100 gastroscope and conscious sedation with midazolam and fentanyl. X-ray contrast was infused into the balloon during dilation and the balloon was monitored by fluoroscopy for presence of a waist. Results: CRE balloons were easy to pass through the instrument channel, and expanded without waisting within the strictures. Dilation was performed in 8 patients with one catheter using the 15 mm - 16.5 mm - 18 mm balloon; 3 patients using 2 catheters with sizes of 12 mm - 13.5 mm followed by 15 mm - 16 mm - 18 mm and in 1 patient with one catheter (12 mm and 13.5 mm) when the procedure was stopped due to severe pain. No perforation occurred and the pain subsided within 10 minutes. Inflation time at each diameter ranged from 30 sec, to 120 sec. Median total inflation time was 240 sec. (range 150 - 360 sec.). Ten of 12 cases were dilatated up to 18 mm, one was dilated to 16.5 mm and the other to 13.5 mm (initial diameter 9 mm). All patients had clinical improvement in dysphagia score of at least 1 grade. No complications occurred. Conclusions: The CRE™ balloons easily and efficiently dilated to 3 diameters without waisting within the strictures and they easily passed through the scope (TTS), successfully accomplishing stricture dilatation. The CRE™ balloon may represent important progress in the TTS technique.

Original languageEnglish (US)
Pages (from-to)AB71
JournalGastrointestinal endoscopy
Volume47
Issue number4
StatePublished - Dec 1 1998

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ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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