Schematic illustration of primary circumferential and secondary focal radiofrequency ablation (RFA) of Barrett's esophagus

(A) Pre-treatment image of a Barrett's segment.
(B) Introduction of the Barrx360 Express balloon catheter over the guidewire.
(C) The inflated balloon positioned 1 cm above the top of the Barrett's segment.
(D) The balloon repositioned for ablation of the second zone after ablation of the first zone with an overlap of 1 cm with the first ablation zone.
(E) Image of the treated Barrett's segment immediately after the RFA ablation with visible necrosis of the superficial mucosa.
(F) Image of the healed distal esophagus three months after RFA treatment with regeneration with neosquamous mucosa and three small islands of residual Barrett's mucosa.
(G) Introduction of the endoscope with the Barrx90 cap for focal ablation.
(H) Ablation of the third island of Barrett's mucosa after ablation of the first two islands. The necrosis caused by ablation of the first two islands is visible.
(I) Image of the healed distal esophagus, showing complete regeneration with neosquamous mucosa.