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Gastrointestinal Endoscopy - truFreeze Spray Cryotherapy

trūFreeze Spray Cryotherapy for Gastrointestinal Applications

trūFreeze spray cryotherapy for gastrointestinal (GI) applications is a non-contact ablation technology that can be used as an adjunct application where other modalities are limited. Endoscopic spray cryotherapy can treat gastrointestinal diseases within the stomach, esophagus, GI tract, and rectum.

Cryotherapy in gastrointestinal endoscopy works by freezing and thawing benign or malignant cells to destroy the diseased tissue. Liquid Nitrogen Spray Cryotherapy (LNSC) can help patients who do not respond to radiofrequency ablation (RFA) for Barrett’s Esophagus, have a history of low pain tolerance, have early-stage esophageal cancer, or need palliative care for late-stage cancer. trūFreeze cryotherapy offers more treatment options and can extend the continuum of care provided to your patients.

trūFreeze cryotherapy – Treat Esophageal Cancer with
the Power of Liquid Nitrogen

Clinical Applications

Liquid Nitrogen (LN2) is the coldest cryogen available and the only cryogen capable of ablating benign and malignant cells in the GI tract. trūFreeze cryotherapy expands a gastroenterologist’s therapeutic options for the following clinical applications.

Select a specific gastrointestinal application to learn more about spray cryotherapy treatment.

Gastrointestinal Application

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

Cryotherapy ESCC Patinet's Clinical Images

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Products

truFreeze Spray Cryotherapy Console
trūFreeze Spray Cryotherapy Console

Used across multiple specialties to deliver liquid nitrogen spray cryotherapy treatments

Rapid AV Catheter - Active Venting
Rapid AV Catheter – Active Venting

Designed to deliver liquid nitrogen to the gastrointestinal tract      

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Videos

trūFreeze cryotherapy – Treat Esophageal Cancer
with the Power of Liquid Nitrogen

trūFreeze Spray Cryotherapy for Esophageal Cancer:
GE Junction Tumor Cryoablation Treatment

Freeze Disease – Managing Complex Esophageal
Neoplasia with Spray Cryotherapy

EndoTalk with Dr. Prasad Iyer – Delaying or Eliminating Stents in Advanced Esophageal Cancer

To watch more videos, please visit the STERIS Endoscopy YouTube Channel.

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Clinical Benefits

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Training

Training is available for physicians and clinical staff members using trūFreeze spray cryotherapy. Our regional Clinical Specialists can provide case support, and experienced physician proctors are available upon request. Use the videos and guides or request an in-service for additional training information.

To contact STERIS Technical Support at 1-800-769-8226.

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Patient Stories

Treating Squamous Cell Esophageal Cancer

Learn how trūFreeze Spray Cryotherapy helped Harold regain control over his life after a Stage 4 metastatic esophageal cancer diagnosis.

Treating Post-Lung Transplant Bronchial Stenosis

With the help of trūFreeze Spray Cryotherapy treatments, hear how Tim Cox improved his quality of life after severe bronchial stenosis following a double lung transplant.

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Literature

BROCHURE
Document # Document Title
TRUFREEZE ENDOSCOPIC ONCOLOGY BROCHURE
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  1. Visrodia Kavel, Zakko Liam, Singh Siddarth, et al. Cryotherapy for persistent Barrett's esophagus after radiofrequency ablation: a systematic review and meta-analysis. Gastrointestinal Endoscopy 2018 Feb; 87(6):p1396-1404.e1. DOI:https://doi.org/10.1016/j.gie.2018.02.021
  2. Kaul Vivek, Bittner Krystle, Ullah Asad, and Kothari Shivangi. Liquid nitrogen spray cryotherapy-based multimodal endoscopic management of dysplastic Barrett's esophagus and early esophageal neoplasia: retrospective review and long-term follow-up at an academic tertiary care referral center. Diseases of the Esophagus. 2020 Apr; 33(4). DOI: 10.1093/dote/doz095
  3. Solomon Sanjeev, Kothari Shivangi, Smallfield George, et al. Liquid Nitrogen Spray Cryotherapy is Associated with Less Postprocedural Pain than Radiofrequency Ablation in Barrett's Esophagus A Multicenter Prospective Study. Journal of Clinical Gastroenterology. 2019 Feb; 53 (2):e84-e90. DOI: 10.1097/MCG.0000000000000999
  4. Shaheen Nicholas J., Falk Gary W., Iyer Prasad G., et al. Diagnosis and Management of Barrett's Esophagus: An Updated ACG Guideline. The American Journal of Gastroenterology. April 2022, 117(4):p 559-587. DOI: 10.14309/ajg.0000000000001680
  5. Sprung Brandon, Granato Christine, Kothari Shivangi, et al. Role of Spray Cryotherapy and Wats in Dysplastic Barrett's Esophagus Refractory to Radiofrequency Ablation. Gastrointestinal Endoscopy 2015 May, 81(5S), p.AB507-AB508. DOI: 10.1016/j.gie.2018.02.021
  6. Safety and Effectiveness of Liquid Nitrogen Spray Cryotherapy-Assisted Balloon Dilation of Refractory Anastomotic Strictures https://www.giejournal.org/article/S0016-5107(23)00675-2/fulltext
  7. CryoDilation: A Novel Treatment for Benign Esophageal Strictures Using Liquid Nitrogen Spray Cryotherapy https://journals.lww.com/ajg/Abstract/2019/10001/1828_CryoDilation__A_Novel_Treatment_for_Benign.1829.aspx
  8. Safety of Same-Session Cryotherapy and Esophageal Stricture Dilation in the Treatment of Esophageal Neoplasia- a Multicenter Study https://www.giejournal.org/article/S0016-5107(15)01970-7/fulltext 
  9. https://journals.lww.com/ajg/Fulltext/2020/10001/S2074_Liquid_Nitrogen_Spray_Cryotherapy_Is_a_Safe.2074.aspx
  10. https://www.videogie.org/article/S2468-4481(21)00004-7/fulltext
  11. Cryotherapy for Management of Transfusion-Dependent Gastrointestinal Hemorrhage Secondary to Gastric Antral Vascular Ectasia https://journals.lww.com/ajg/Fulltext/2019/10001/Cryotherapy_for_Management_of.2163.aspx
  12. Hanada Yuri and Wang Kenneth. Cryotherapy for Management of Transfusion-Dependent Gastrointestinal Hemorrhage Secondary to Gastric Antral Vascular Ectasia. The American Journal of Gastroenterology. Oct 2019. 114():p S1207. DOI: 10.14309/01.ajg.0000598180.51180.80
  13. Radiation Proctitis: Efficacy of cryospray ablation for the treatment of chronic radiation proctitis in a pilot study https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1443-1661.2012.01355.x
  14. Effect of Bronchoscopic Spray Cryotherapy and Ultra-low Temperature on Physical Properties of Metallic and Silicone Airway Stents https://journals.lww.com/bronchology/Abstract/2023/01000/Effect_of_Bronchoscopic_Spray_Cryotherapy_and.6.aspx
  15. SEER., Cancer Stat Facts: Esophageal Cancer. https://seer.cancer.gov/statfacts/html/esoph.html 2021
  16. Nehra Akhil, Leggett Cadman L., Lutzke Lori S, et al. Palliative Cryoablation for Patients with Unresectable Esophageal Adenocarcinoma. Gastrointestinal Endoscopy 2014; 79 (5S): AB508. DOI: https://doi.org/10.1016/j.gie.2014.02.797
  17. Włodarczyk JR, Kużdżał J. Stenting in Palliation of Unresectable Esophageal Cancer. World J Surg. 2018; 42(12): 3988-3996. DOI: https://doi.org/10.1007/s00268-018-4722-7
  18. Greenwald BD, et al. “Endoscopic spray cryotherapy for esophageal cancer: safety and efficacy.” Gastrointestinal Endoscopy. 2010: Volume 71, No. 4, p686-693. http://www.giejournal.org/article/S0016-5107%2810%2900056-8/abstract
  19. Tsai FC, et al. “Safety and efficacy of endoscopic spray cryotherapy for esophageal cancer,” Diseases of the Esophagus, November 2017, Volume 30, Issue 11 p 1-7. https://doi.org/10.1093/dote/dox087
  20. Kachaamy Toufic, Sharma Neil, Pannala Rahul, et al. Cryotherapy in Addition to Chemotherapy for Palliation of Inoperable Esophageal Cancer: A multi-center prospective study. Journal of Clinical Oncology 2020; 38:4_suppl, 342 – 342. DOI: https://doi.org/10.1200/JCO.2020.38.4_suppl.342
  21. Hanada Y, Leggett CL, Iyer PG, et al. Spray Cryotherapy Prevents Need for Palliative Stenting in Patients with Esophageal Cancer-Associated Dysphagia. Dis Esophagus. 2022; 35 (1): doab051. DOI: https://doi.org/10.1093/dote/doab051
  22. Prakash Ravi, Kachaamy Toufic, Ambrosius Michele, et al. Impact of Liquid Nitrogen Endoscopic Spray Cryotherapy on Overall Survival in Metastatic Esophageal Cancer. Gastrointestinal Endoscopy 2017; 85: AB603 – AB604. DOI: https://doi.org/10.1016/j.gie.2017.03.1394
  23. Trindade AJ, et al. “Feasibility of Liquid Nitrogen Cryotherapy after Failed Radiofrequency Ablation for Barrett's Esophagus”, Digestive Endoscopy. 2017 Mar 16. https://www.ncbi.nlm.nih.gov/pubmed/28303613
  24. Sengupta N, et al. “Salvage cryotherapy after failed radiofrequency ablation for Barrett's esophagus-related dysplasia is safe and effective.” Gastrointestinal Endoscopy. 2015: Volume 82, Issue 3, p443-448. DOI: https://doi.org/10.1016/j.gie.2015.01.033
  25. Mohan B.P., et. al. “Liquid Nitrogen in the Treatment of Barrett's Esophagus, where do we stand? A Systematic Review and Meta-Analysis”, Diseases of the Esophagus, 2019, DOI: 10.1093/dote/doy130. https://doi.org/10.1093/dote/doy130
  26. Eluri S, et al., “Durability Of Successful Eradication Of Barrett's Esophagus With Liquid Nitrogen Spray Cryotherapy: Results Of A U.S. Multicenter Registry,” Oral Abstract. Gastrointestinal Endoscopy, Volume 89, Issue 6, Supplement, AB98-AB99, June 01, 2019. DOI: https://doi.org/10.1016/j.gie.2019.04.093
  27. Ghorbani S, et al. “Safety and efficacy of endoscopic spray cryotherapy for Barrett's dysplasia: results of the National Cryospray Registry.” Diseases of the Esophagus. 2015: 29: p241–247. DOI: 10.1111/dote.12330 https://onlinelibrary.wiley.com/doi/abs/10.1111/dote.12330
  28. Chandan Saurabh, Babaye Jay, Khan Shahab, et al. Safety and Efficacy of Liquid Nitrogen Spray Cryotherapy in Barrett's Neoplasia – A Comprehensive Review and Meta-Analysis. Endoscopy Int Open 2022; 10(11): E1462-E1473. DOI: 10.1055/a-1906-4967
  29. Shaheen NJ, et al. “Safety and efficacy of endoscopic spray cryotherapy for Barrett's esophagus with high-grade dysplasia.” Gastrointestinal Endoscopy. 2010: Volume 71, No. 4, p680-685. http://www.giejournal.org/article/S0016-5107%2810%2900031-3/abstract B
  30. Gosain S, et al. “Liquid nitrogen spray cryotherapy in Barrett's esophagus with high-grade dysplasia: long-term results.” Gastrointestinal Endoscopy. 2013: Volume 78, Issue 2, p260-265. DOI: https://doi.org/10.1016/j.gie.2013.03.002
  31. Ramay FH, et al. “Outcomes after liquid nitrogen spray cryotherapy in Barrett's esophagus-associated high-grade dysplasia and intramucosal adenocarcinoma: 5-year follow-up.” Gastrointestinal Endoscopy. 2017 Oct;86(4):626-632. https://www.ncbi.nlm.nih.gov/pubmed/28235596
  32. Shaheen NJ, Sharma P, Overholt BF, Wolfsen HC, Sampliner RE, Wang KK, Galanko JA, Bronner MP, Goldblum JR, Bennett AE, Jobe BA, Eisen GM, Fennerty MB, Hunter JG, Fleischer DE, Sharma VK, Hawes RH, Hoffman BJ, Rothstein RI, Gordon SR, Mashimo H, Chang KJ, Muthusamy VR, Edmundowicz SA, Spechler SJ, Siddiqui AA, Souza RF, Infantolino A, Falk GW, Kimmey MB, Madanick RD, Chak A, Lightdale CJ. Radiofrequency ablation in Barrett's esophagus with dysplasia. N Engl J Med. 2009 May 28;360(22):2277-88. doi: 10.1056/NEJMoa0808145. PMID: 19474425.
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