Original articleGeneral thoracicEndobronchial and Endoscopic Ultrasound-Guided Transvascular Biopsy of Mediastinal, Hilar, and Lung Lesions
Section snippets
Patients and Methods
Patients were retrospectively identified from a prospective database of the Centre Hospitalier de l’Universite de Montreal Endoscopic Tracheo-Bronchial and Oesophageal Center, Division of Thoracic Surgery, University of Montreal. The Institutional Ethics Committee Board of the Centre Hospitalier de l’Universite de Montreal approved the study.
As described above, the risk of the procedure was deemed acceptable, and specific consent for the transvascular approach was not taken before the procedure.
Results
The study included 33 consecutive patients, 20 women and 13 men, with suspected or proven malignancy who underwent EBUS- or EUS-guided biopsy of lesions distal to the aorta or pulmonary artery branch between January 14, 2011, and September 3, 2015. Patients were a mean age of 64 years (range, 47 to 83 years; Table 1). Nine patients had known extrathoracic malignancy.
The biopsy was performed using a 21-gauge needle under EBUS guidance in 14 patients and using a 22-gauge needle under EUS guidance
Comment
Endoscopic techniques, including EBUS and EUS, are the recommended initial approach for the diagnosis and staging of lung cancer and the preferred method for diagnosis of mediastinal masses and lymphadenopathy. Endoscopic techniques have an excellent safety profile, and severe bleeding from ultrasound-guided biopsy remains exceedingly rare. In a large retrospective multicenter review of 7,345 procedures in 210 facilities by Asano and colleagues [13], hemorrhage was seen in 50 patients (0.68%),
References (27)
- et al.
Efficacy of endobronchial ultrasound-guided transbronchial needle aspiration of hilar lymph nodes for diagnosing and staging cancer
J Thorac Oncol
(2009) - et al.
A prospective controlled trial of endobronchial ultrasound-guided transbronchial needle aspiration compared with mediastinoscopy for mediastinal lymph node staging of lung cancer
J Thorac Cardiovasc Surg
(2011) - et al.
Methods for staging non-small cell lung cancer. Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines
Chest
(2013) - et al.
Combined endobronchial and endoscopic ultrasound-guided fine needle aspiration for mediastinal lymph node staging of lung cancer: a meta-analysis
Eur J Cancer
(2013) - et al.
Economic analysis of combined endoscopic and endobronchial ultrasound in the evaluation of patients with suspected non-small cell lung cancer
Lung Cancer
(2010) - et al.
New technique performed by using EUS access for biopsy of para-aortic (station 6) mediastinal lymph nodes without traversing the aorta (with video)
Gastrointest Endosc
(2011) - et al.
Methods for staging non-small cell lung cancer. American College of Chest Physicians evidence based clinical practice guidelines
Chest
(2013) - et al.
Successful real-time endobronchial ultrasound-guided transbronchial needle aspiration of hilar lung mass obtained by traversing the pulmonary artery
J Thorac Oncol
(2006) - et al.
Complications, consequences, and practice patterns of endobronchial ultrasound-guided transbronchial needle aspiration: results of the AQuIRE registry
Chest
(2013) - et al.
A new approach to the neurolytic block of the coeliac plexus: the transaortic technique
Pain
(1983)
Percutaneous pulmonary endoarterial biopsy in an experimental model of pulmonary hypertension
Chest
Transaortic fine-needle aspiration of centrally located lung cancer under endoscopic ultrasound guidance: the final frontier
Ann Thorac Surg
Transaortic EUS-guided FNA in the diagnosis of lung tumors and lymph nodes
Gastrointest Endosc
Cited by (27)
Thrombolysis of Pulmonary Emboli via Endobronchial Ultrasound-Guided Transbronchial Needle Injection
2021, Annals of Thoracic SurgeryCitation Excerpt :EBUS-TBNA is an established modality for the diagnosis of mediastinal and centrally located peribronchial lesions. The feasibility and safety of EBUS-guided transpulmonary artery needle aspiration for the diagnosis of lesions seen in the lumen of the pulmonary artery has been reported by others.15-17 Our findings support the feasibility of EBUS-TBNI thrombolysis for central pulmonary emboli.
Transvascular endosonographic-guided needle biopsy of intrathoracic lesions
2020, Journal of Thoracic and Cardiovascular SurgeryEsophageal ultrasound with ultrasound bronchoscope (EUS-B) guided transvascular needle aspiration (TVNA)
2019, Respiratory Medicine Case ReportsCitation Excerpt :Since then endoscopic transvascular needle aspiration (TVNA) has revolutionized the diagnostic approach to mediastinal diseases. Recently, endobronchial ultrasound (EBUS) TVNA has also been described for the diagnosis of lung and/or mediastinal lesions [1]. We performed an endobronchial ultrasound using ultrasound bronchoscope (EUS-B) guided TVNA.
The Latest in Endobronchial Ultrasound and Lung Cancer
2018, Archivos de Bronconeumologia