Arch Iran Med. 2021;24: 862-868.
doi: 10.34172/aim.2021.129
  Abstract View: 453
  PDF Download: 280

Original Article

Safety and Efficacy of Graded Gradual Pneumatic Balloon Dilation in Idiopathic Achalasia Patients: A 24-Year Single-Center Experience

Narges Fazlollahi 1 ORCID logo, Amir Anushiravani 1, Maryam Rahmati 2, Mohammad Amani 1, Hossein Asl-Soleimani 1, Melineh Markarian 1, Alice Chu Jiang 3, Javad Mikaeli 1* ORCID logo

1 Autoimmune and Motility Disorders Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
2 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University, Tehran, Iran
3 Division of Digestive Diseases, Rush University Medical Center, Chicago, USA
*Corresponding Author: *Corresponding Author: Javad Mikaeli, MD; Digestive Diseases Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Karegar Shomali Ave., Tehran 14117-13135, Iran. Tel:+98-21-82415000; Fax:+98-21-82415400; Email: , Email: mikaeli@ams.ac.ir


Background: Pneumatic balloon dilation (PBD) is a first line treatment for idiopathic achalasia. Here we report the safety and efficacy of graded gradual PBD on short and long-term follow-up.

Methods: We evaluated 1370 idiopathic achalasia patients over a period of 24 years (1994-2018), prospectively. 216 patients did not undergo PBD due to comorbid diseases. Ultimately, 1092 achalasia patients were enrolled. All patients underwent graded gradual PBD, with repeat dilation if symptoms relapsed. Response to treatment was evaluated by Vantrappen scoring system.

Results: Of 1092 achalasia patients, 937 patients were treated by PBD and 155 patients were treated by combined therapy (PBD 1 month after Botulinum toxin injection). In short-term follow-up, 728 of 1092 patients underwent one PBD and 77.3% of them had excellent or good response (responders), 163 patients (58.6%) who underwent two PBDs were responders, and 44 (51.2%) patients who underwent three PBDs were responders. Overall, 2193 balloon dilations were performed on 1092 patients (mean 2 PBDs/patient). Of 786 patients with long-term follow-up, 259 patients had excellent or good response with one PBD. The responders with two, three, and four or more dilations were 149, 67, and 67, respectively. The overall response rate was 69%. No any serious complications were noted by using the graded gradual method.

Conclusion: Our results show that graded gradual PBD is a safe and effective method for treatment of achalasia patients, and achieves sufficient short and long-term symptomatic remission with high cumulative success rate.

Keywords: Achalasia, Efficacy, Pneumatic balloon dilation, Safety

Cite this article as: Fazlollahi N, Anushiravani A, Rahmati M, Amani M, Asl-Soleimani H, Markarian M, et al. Safety and efficacy of graded gradual pneumatic balloon dilation in idiopathic achalasia patients: a 24-year single-center experience. Arch Iran Med. 2021;24(12):862-868. doi: 10.34172/aim.2021.129
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Submitted: 08 Nov 2020
Revision: 06 May 2021
Accepted: 19 May 2021
ePublished: 01 Dec 2021
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