Initial Clinical Experience With a Flexible Peripheral 21-G Needle Device

Tremblay, Alain; Myers, Renelle; Beaudoin, Ève-Léa; Bonifazi, Martina; Delage, Antoine; Fortin, Marc; Hergott, Christopher A.; MacEachern, Paul; Shaipanich, Tawimas; Shieh, Benjamin; Gasparini, Stefano; Lam, Stephen

doi:10.1097/lbr.0000000000000505

Cited by 13 publications

(5 citation statements)

References 6 publications

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“…A new 21-gauge needle can be used through a 1.7-mm working channel of an ultrathin bronchoscope. Conventional bronchoscopic aspiration needles are stiff, and their steerability and accessibility in the peripheral lung are quite limited (21), while the flexibility of the new needle facilitates TBNA procedures for PPLs (49). The use of TBNA seems to be reasonable in certain cases (e.g., lesions into which rEBUS cannot be inserted), as TBNA can be used to gain access and obtain specimens from peribronchial lesions.…”

Section: Future Perspectivesmentioning

confidence: 99%

Diagnostic value of ultrathin bronchoscopy in peripheral pulmonary lesions: a narrative review

Oki¹,

Sasaki²

2020

J Thorac Dis

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Flexible bronchoscopes are being continuously improved, and an ultrathin bronchoscope with a working channel that allows the use of a radial-type endobronchial ultrasound (EBUS) probe is now available. The ultrathin bronchoscope has good maneuverability for passing through the small bronchi and good accessibility to peripheral lung lesions. This utility is particularly enhanced when it is used with other imaging devices, such as EBUS and navigation devices. Multimodality bronchoscopy using an ultrathin bronchoscope leads to enhanced diagnostic yield.

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Section: Future Perspectivesmentioning

confidence: 99%

Diagnostic value of ultrathin bronchoscopy in peripheral pulmonary lesions: a narrative review

Oki¹,

Sasaki²

2020

J Thorac Dis

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“…To improve the diagnostic yield for PPLs inside or near emphysema areas, additional conventional transbronchial lung biopsy (TBLB) after EBUS-GS-TBB may be effective if a larger tissue sample is obtained [22]. Furthermore, transbronchial needle aspiration through a GS using the PeriView FLEX needle may improve the diagnostic yield by penetrating the lesions and collecting samples [23,24]; the diagnostic yield may also be improved using EBUS-GS transbronchial lung cryobiopsy to obtain adequate samples [25].…”

Section: Discussionmentioning

confidence: 99%

Utility of Radial Endobronchial Ultrasound with a Guide Sheath for Peripheral Pulmonary Lesions in Patients with Pulmonary Emphysema: A Retrospective Study

Zhou

Feng

Wang

et al. 2022

Preprint

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Background: Radial endobronchial ultrasound with a guide sheath for transbronchial biopsy (EBUS-GS-TBB) can be considered for diagnosing peripheral pulmonary lesions (PPLs) with fewer complications in patients with emphysema. However, the utility and safety of bronchoscopy for PPLs in the proximity of emphysema-area lesions remain unclear. The aim of this study was to assess the efficacy and complications of the initial diagnostic procedure of bronchoscopy with EBUS-GS-TBB according to the proximity of PPLs to emphysema areas, along with factors affecting the successful diagnostic yield for PPLs, and to identify the feasibility of molecular and genetic testing using EBUS-GS-TBB-obtained tumor samples.Methods: The medical records of 278 consecutive patients with PPLs who underwent EBUS-GS-TBB without X-ray fluoroscopy guidance were screened. We compared PPLs with emphysema in such lesions. PPLs with emphysema were divided into two groups: PPLs located in non-emphysema areas and those inside or near emphysema areas.Results: This study included 84 patients with emphysema (non-emphysema area group=46; inside or near emphysema area group=38). The diagnostic yield was significantly higher for PPLs located in non-emphysema areas than for PPLs inside or near emphysema areas (82.6% vs. 52.6%, p=0.013). Multivariate analysis revealed that PPLs located in non-emphysema areas (odds ratio=5.614) and EBUS images within lesions were significant factors affecting diagnostic yield. Further, 91.7%–100% of EBUS-GS-TBB-obtained tissue samples were sufficient for molecular testing of PD-L1, EGFR, ALK, and ROS1.Conclusions: In patients with emphysema, the positional relation of PPLs to emphysema lesions and EBUS images within lesions were important factors affecting successful diagnosis using EBUS-GS-TBB.

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“…To improve the diagnostic yield for PPLs within or near fibrotic lesions, methods of additional conventional transbronchial biopsy after EBUS-GS TBB may be effective by obtaining larger samples [24]. Furthermore, transbronchial needle aspiration through a GS using the PeriView FLEX transbronchial needle aspiration device may improve diagnostic yield by penetrating the lesion and collecting samples [25][26][27].…”

Section: Discussionmentioning

confidence: 99%

Endobronchial Ultrasonography with a Guide Sheath Transbronchial Biopsy for Diagnosing Peripheral Pulmonary Lesions within or near Fibrotic Lesions in Patients with Interstitial Lung Disease

Itō

Okachi

Kimura

et al. 2021

Cancers

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In patients with interstitial lung disease (ILD), the most frequent locations of lung cancer are within or near fibrotic lesions. However, the diagnostic yield for peripheral pulmonary lesions (PPLs) within or near fibrotic lesions using endobronchial ultrasonography with a guide sheath transbronchial biopsy (EBUS-GS TBB) may be unsatisfactory compared to that for PPLs distant from fibrotic lesions because of the difficulty in reaching the lesions. Our objectives were to evaluate the yield for PPLs using EBUS-GS TBB according to the proximity of PPLs to fibrotic lesions and to determine factors affecting the yield for PPLs. We retrospectively investigated 323 consecutive lesions using EBUS-GS TBB between 1 November 2014 and 31 December 2016. We identified PPLs with ILD in such lesions. PPLs with ILD were divided into PPLs within or near fibrotic lesions which met the criterion of PPLs, and of fibrotic lesions overlapping each other (PPLs-FL) and those distant from fibrotic lesions, which met the criterion of PPLs and the area of fibrotic lesion not overlapping each other (PPLs-NFL). Of the 323 lesions, 55 were included (31 PPLs-FL and 24 PPLs-NFL). The diagnostic yield for PPLs-FL was significantly lower than for PPLs-NFL (45.2% vs. 83.3%, p = 0.004). Multivariate analysis revealed that PPLs-NFL (odds ratio (OR) = 7.509) and a probe position within the lesion (OR = 4.172) were significant factors affecting diagnostic yield. Lesion’s positional relation to fibrotic lesions and the probe position were important factors affecting the successful diagnosis via EBUS-GS TBB in these patients.

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Initial Clinical Experience With a Flexible Peripheral 21-G Needle Device

Cited by 13 publications

References 6 publications

Diagnostic value of ultrathin bronchoscopy in peripheral pulmonary lesions: a narrative review

Diagnostic value of ultrathin bronchoscopy in peripheral pulmonary lesions: a narrative review

Utility of Radial Endobronchial Ultrasound with a Guide Sheath for Peripheral Pulmonary Lesions in Patients with Pulmonary Emphysema: A Retrospective Study

Endobronchial Ultrasonography with a Guide Sheath Transbronchial Biopsy for Diagnosing Peripheral Pulmonary Lesions within or near Fibrotic Lesions in Patients with Interstitial Lung Disease

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