Feasibility of Performing Transvascular Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

Naaman, Rami; Lautenschlaeger, Tim; Diab, Khalil

doi:10.1016/j.cllc.2020.10.020

Cited by 5 publications

(9 citation statements)

References 25 publications

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“…The search strategy yielded 173 records of which 114 were screened after removal of duplicate records. After assessing for eligibility, a total of 17 studies 10–26 with 411 patients were included in the final analysis. Figure 1 shows the PRISMA flowchart for study selection and inclusion.…”

Section: Resultsmentioning

confidence: 99%

“…Study by Naaman et al reported a total of four major adverse events in their series of 35 patients who underwent EBUS‐guided TVNA, of which two were self‐limited episodes of hemoptysis, one with acute exacerbation of COPD requiring ICU stay and one developed atrial fibrillation which was reversed with anti‐arrythmics 25 . Von Bartheld et al published a series of 14 patients undergoing transaortic EUS guided TVNA of periaortic masses.…”

Section: Discussionmentioning

confidence: 99%

“…The search strategy yielded 173 records of which 114 were screened after removal of duplicate records. After assessing for eligibility, a total of 17 studies [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] with 411 patients were included in the final analysis.…”

Section: Study Characteristics and Quality Analysismentioning

confidence: 99%

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Efficacy and safety of endosonography‐guided transvascular needle aspiration of thoracic and abdominal lesions: A systematic review and meta‐analysis

Giri

Harindranath

Angadi

et al. 2023

J of Clinical Ultrasound

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Background The diagnosis of intrathoracic and abdominal masses is challenging when lesions are located behind major vessels. Endoscopic ultrasound (EUS) or endobronchial ultrasound (EBUS)‐guided transvascular needle aspiration (TVNA) provides a potentially useful diagnostic tool for such lesions. Data with respect to the safety and outcome of E‐TVNA are scarce. Hence, this meta‐analysis was conducted to assess the critical role of E‐TVNA for diagnosis of various lesions. Methods and Material A meta‐analysis was performed by pooling the data from studies obtained from comprehensive search of Medline, Embase, and Scopus from January 2000 to September 2022. The outcomes analyzed included sample adequacy, diagnostic accuracy and adverse events including bleeding. Results A total of 17 studies (n = 411) were included in the final analysis. The pooled rate of sample adequacy was 91.5% [95% confidence interval (CI): 86.8–96.2], while the pooled rate of diagnostic accuracy was 85.0% (95% CI: 78.9–91.2). The pooled rate of bleeding with E‐TVNA was 1.4% (95% CI 0.0–3.1%). All the episodes of bleeding were mild and resolved without any further intervention. There was no significant heterogeneity with respect to various outcomes and results were comparable on sensitivity analysis. Conclusions E‐TVNA offers a safe and accurate diagnostic modality for the diagnosis of mediastinal and abdominal lesions located on the other side of major vessels. Selection of potential candidates and close periprocedural observation are essential to improve the outcome.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Efficacy and safety of endosonography‐guided transvascular needle aspiration of thoracic and abdominal lesions: A systematic review and meta‐analysis

Giri

Harindranath

Angadi

et al. 2023

J of Clinical Ultrasound

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“…Therefore, the keys to a successful procedure are adequate perioperative planning and monitoring and taking precautions like having a cardiothoracic surgical team on standby. EBUS/EUS-TVNA should preferably be attempted in a high-volume center by skilled interventional pulmonologists with the patient under sedation or general anesthesia [19].…”

Section: Discussionmentioning

confidence: 99%

“…Subsequently, the feasibility and safety of these procedures have been evaluated in a series of clinical studies [9][10][11][12][13][14][15][16][17][18]. Furthermore, the important precautions and technical aspects of EBUS-TBNA and EUS-FNA have been discussed [19]. We performed the present systematic review and meta-analysis of published studies to investigate the diagnostic yield and safety profile of EBUS/ EUS-guided transvascular needle aspiration (EBUS/EUS-TVNA) in patients with thoracic or abdominal lesions.…”

Section: Introductionmentioning

confidence: 99%

Feasibility and Safety of Endosonography-Guided Transvascular Needle Aspiration in the Diagnosis of Thoracic and Abdominal Lesions: A Meta-Analysis

Yang

Zhang

et al. 2023

Respiration

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Background: Endoscopic techniques, including endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS), are used as the initial approach for the diagnosis and staging of lung cancer and the diagnosis of thoracic and abdominal lesions. Historically, the transvascular approach has been avoided because of concerns about bleeding. Objectives: This article is a systematic review of studies evaluating the feasibility and safety of transvascular needle aspiration (TVNA) under the guidance of EBUS or EUS in the diagnosis of thoracic and abdominal lesions. Methods: We performed a systematic search of the MEDLINE, Embase, and Cochrane databases to identify studies evaluating the application of EBUS/EUS-guided TVNA (EBUS/EUS-TVNA) for lesions located at the contralateral side of the vessel for which the transvascular approach was the best puncture path. We performed a meta-analysis of diagnostic yield estimations. We also reviewed the complications related to the procedure. Results: Eleven observational studies were included in the final analysis. Meta-analysis yielded a pooled overall diagnostic yield of 82.10% (95% confidence interval, 0.74–0.89) for TVNA, with an I2 value of 52%. No publication bias was detected by Egger’s test (p = 0.8528). The overall complications included minor bleeding, minor hematoma, pseudoaneurysm of the aorta, hemoptysis, acute hypoxic respiratory failure, and moderate bleeding. The major complication rate was 2.71%. Conclusions: EBUS/EUS-TVNA is feasible and probably safe when performed by experienced endoscopists in carefully selected patients. In view of the potential risks associated with the transvascular approach, especially the development of hematoma and pseudoaneurysm, the fanning technique was avoided, and the area of aspiration should be assessed by EUS for 3 min after each aspiration. Most importantly, EBUS/EUS-TVNA should only be performed if the results will impact the clinical management.

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Assessment of effectiveness and safety of thrombolytic therapy to pulmonary emboli by endobronchial ultrasound-guided transbronchial needle injection

Sata,

Aragaki,

Inage

et al. 2023

JTCVS Techniques

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Feasibility of Performing Transvascular Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

Cited by 5 publications

References 25 publications

Efficacy and safety of endosonography‐guided transvascular needle aspiration of thoracic and abdominal lesions: A systematic review and meta‐analysis

Efficacy and safety of endosonography‐guided transvascular needle aspiration of thoracic and abdominal lesions: A systematic review and meta‐analysis

Feasibility and Safety of Endosonography-Guided Transvascular Needle Aspiration in the Diagnosis of Thoracic and Abdominal Lesions: A Meta-Analysis

Assessment of effectiveness and safety of thrombolytic therapy to pulmonary emboli by endobronchial ultrasound-guided transbronchial needle injection

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