An appropriately sized HALO360+ Ablation Catheter is introduced over a guidewire.
The endoscope is inserted in a side-by-side manner with the ablation catheter. The balloon electrode is positioned under direct visualization so that the proximal edge of the electrode is slightly above the top of the intestinal metaplasia.
The balloon is automatically inflated and energy applied at 300 W and 10 J/cm2 (or 12 J/cm2 as appropriate).
The electrode is then moved distally by 3 cm, aligning the proximal edge of the electrode with the distal edge of the ablation zone. Inflation and ablation is repeated until the top of the gastric folds is reached.
The ablation catheter is removed, cleaned, and reintroduced. The ablation zone is cleaned of coagulative debris with irrigation and suction using the endoscope.
The ablation catheter is positioned under direct visualization so that the proximal edge of the electrode was at the proximal edge of the ablation zone. Inflation, ablation, and repositioning is repeated as in the first set of treatments.
The ablation catheter and guidewire are removed and an esophagoscopy confirms complete ablation of all intestinal metaplasia.