trūFreeze Spray Cryotherapy for Gastrointestinal Applications

Esophageal Cancer

Spray cryotherapy can be a life-changing GI Intervention for esophageal cancer patients. Regardless of disease stage, patients can experience actual benefits with trūFreeze:

• Safe and well-tolerated at any stage
• Better quality of life / Improved dysphagia relief
• Prevents or delays the need for stent placement
• Effective in combination with systemic therapy
• Reduces post-procedure pain compared to thermal ablation

Reference the Endoscopic Oncology Brochure for more details.

Advanced Metastatic Squamous Cell Esophageal Cancer

• Link to Reference Brochure

Barrett’s Esophagus

Research has shown that 10-33% of patients are Refractory to RFA. Liquid Nitrogen Spray Cryotherapy (LNSC) is clinically proven effective in treating patients suffering from refractory Barrett's Esophagus after radiofrequency ablation (RFA) treatment.^1,2 LNSC is also an option for challenging Barrett's Esophagus patients or those sensitive to thermal ablation pain.³

"A systematic review reported CE-D and CE-IM rates of 76% and 46% in patients with dysplastic BE refractory to initial RFA who were treated with spray cryotherapy." ⁴

"RFA treatment failures represent a clinical challenge. Spray cryotherapy has shown complete remission of intestinal metaplasia (CR-IM) in 57-78% of patients in this population." ⁵

Case Report:

Patients with benign esophageal disease progressed to low-grade dysplasia (LGD) and then to high-grade dysplasia (HGD) over three years, at which point two spray cryotherapy (SCT) procedures were performed. Biopsies at the three-month follow-up showed normal squamous mucosa and gastric tissue.

Case courtesy of Bruce Greenwald, MD (University of Maryland)

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Benign Refractory Strictures

CryoDilation (Spray Cryotherapy + Balloon Dilation) is a new and novel technique that elicits a non-fibrotic wound response, unlike burning or cutting modalities, and thus tends to be minimally scarring.

Refractory patients often return within weeks for repeat procedures, which can persist for years. CryoDilation is an adjunctive treatment modality for refractory strictures that have not responded to other therapies. Read more about this approach in the research links provided in the references section.^6,7,8

• Link to Reference 6
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Gastric Cancer

There are very few treatment modalities available for gastric intestinal metaplasia with dysphagia. Liquid Nitrogen Spray Cryotherapy is a safe, well-tolerated, and effective treatment for extensive GIM-D.⁹

A series of cases is available at Video GIE with physicians using Liquid Nitrogen cryotherapy for gastric intestinal metaplasia.¹⁰

• Link to Reference 9
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Gastric Antral Vascular Ectasia (GAVE)

In a recent peer-reviewed case, a transfusion-dependent patient received three LNC sessions at 1-month intervals, then one additional LNC session three months out. Transfusional support was discontinued after three sessions of LNC as the patient's hemoglobin normalized. EGD six months out showed the patient's GAVE symptoms had improved.^{11, 12}

• Link to Reference 11
• Link to Reference 12

Radiation Proctitis

A recent prospective case-series pilot summarized cryotherapy as a novel and effective method of managing chronic radiation proctitis with minimal complications.¹³

• Link to Reference 13

Stent Management

trūFreeze Liquid Nitrogen Spray Cryotherapy (LNSC) can be utilized to aid in removing Ingrown Partially Covered Stents.

• A patient was experiencing pain with reflux, irritation, and benign narrowing. The patient was diagnosed with peptic stricture, and a partially covered stent was placed (A). They were referred to a thoracic surgeon after reporting 24/7 pain, food impaction, and weight loss.
• The stent was placed within the original stent, and Liquid Nitrogen Spray Cryotherapy (LNSC) was applied. Both stents were released from tissue and successfully removed (B) with minimal bleeding (C). The patient's esophagus was re-epithelized (D).¹⁴

Courtesy of Eric Sceusi, MD