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 journalArticlepeer-review

15 Scopus citations


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 languageEnglish (US)
Pages (from-to)1251-1257
Number of pages7
JournalGastrointestinal endoscopy
Issue number6
StatePublished - Nov 2020

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.

Publisher Copyright:
© 2020 American Society for Gastrointestinal Endoscopy


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