A New Endoscopic Device to Facilitate APC Treatment: First Multicenter Clinical Experience

Background and Study Aims Argon plasma coagulation (APC) is an established ablation technique, but limited by tangential probe orientation. ArgoCap was developed to allow precise, safe, and reproducible APC through visualizing the argon beam, shielding the probe, maintaining a defined distance, and enabling hybrid APC procedures. This study aimed to evaluate the clinical feasibility and safety of ArgoCap across multiple indications. Patients and Methods Between January 2022 and May 2025, 54 APC procedures using the ArgoCap were performed at three expert centers. Indications included Barrett's mucosa, ectopic gastric mucosa, gastric angioectasia, gastric antral vascular ectasia, radiation proctitis, and other indications. Primary endpoint was technical success, defined as access to the lesions and macroscopically complete ablation. Secondary endpoints included technical complications, adverse events, and procedural time. Results The majority of lesions were located in the esophagus (70%), followed by stomach (19%) and rectum (11%). Median lesion size was 13 mm (range 2-240 mm). Median ablation and procedure times were 8 min (2-15 min) and 25 min (8-75 min), respectively. Technical success was achieved in 47 cases (87%); subtotal ablation (>90% of the lesion) was possible in 52 cases (96%). Technical difficulties occurred in 1 case (2%); primary complication (ulceration with subsequent bleeding) was observed in 1 case (2%). Conclusions The ArgoCap enables easy and precise APC in the upper and lower gastrointestinal tract across multiple indications. It facilitates lesion access and visualization, reduces unintended mucosal contact, and allows hybrid APC procedures.