Paclitaxel-Coated Balloon Dilator for Recurrent Oesophagal Strictures: GIE | May 2026

Introduction:

Recurrent esophageal strictures remain a frustrating clinical problem, often requiring repeated endoscopic dilations with persistent dysphagia and reduced quality of life. Although conventional balloon dilation effectively relieves obstruction, it does not prevent restricture formation. This first U.S. prospective multicenter study evaluated a paclitaxel-coated balloon (DCB) dilator, designed to combine mechanical dilation with local delivery of an antifibrotic drug to reduce stricture recurrence.

Why was this study needed?

Recurrent esophageal strictures frequently require repeated endoscopic dilations.

Conventional balloon dilation treats the narrowing but does not prevent fibrosis and restricture.

Repeated procedures increase healthcare utilization and negatively impact patient quality of life.

Local delivery of paclitaxel may inhibit scar formation while minimizing systemic drug exposure.

Prospective clinical data on drug-coated balloon technology in esophageal strictures have been lacking.

Results:

This prospective multicenter U.S. study included 25 patients with recurrent esophageal strictures, most of whom had peptic strictures and had previously undergone a median of six endoscopic dilations.

Following treatment with the paclitaxel-coated balloon, 40% of patients remained free from stricture recurrence at 12 months, representing a substantial improvement compared with their historical recurrence patterns.

Patients experienced significant improvement in dysphagia symptoms and quality of life, as demonstrated by improvements in both the Ogilvie Score and Dysphagia Handicap Index (DHI).

Systemic absorption of paclitaxel was minimal, with only low, transient drug levels detected in a small number of patients.

No treatment-related adverse events were reported, supporting the safety of this local drug-delivery approach.

Clinical Impact:

This first U.S. experience suggests that paclitaxel-coated balloon dilation may represent a major advance in the management of recurrent benign esophageal strictures. By combining mechanical dilation with localized antifibrotic therapy, the technique has the potential to reduce the need for repeated endoscopic interventions while improving long-term symptom control. If confirmed in ongoing randomized controlled trials, drug-coated balloon technology could become an important addition to the therapeutic options for patients with refractory esophageal strictures.

Bottom Line:

Paclitaxel-coated balloon dilation significantly reduced recurrence of recurrent esophageal strictures, improved dysphagia, and demonstrated minimal systemic drug exposure with an excellent safety profile. This novel technology offers a promising strategy to reduce repeat dilations and improve long-term outcomes, pending confirmation in randomized clinical trials.