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Usefulness of an angioplasty balloon as selective bronchial blockade device after transbronchial cryobiopsy
Author(s) -
EchevarriaUraga José Javier,
PérezIzquierdo Julio,
GarcíaGarai Nerea,
GómezJiménez Estíbaliz,
AramburuOjembarrena Amaia,
TenaTudanca Luis,
MiguélezVidales José L.,
CapelasteguiSaiz Alberto
Publication year - 2016
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12827
Subject(s) - medicine , fluoroscopy , radiology , balloon , pulmonologist , pneumothorax , angioplasty , surgery , intensive care medicine
Abstract Background and objective Transbronchial cryobiopsy (TBCB) is a technique in which frozen samples of lung are obtained using a probe inserted through a bronchoscope. We performed a retrospective study to assess the performance of the TBCB procedure complemented by segmental bronchial blockade using an angioplasty balloon, in terms of diagnostic yield and safety in diffuse parenchymal lung disease (DPLD). Methods Data from 100 patients with suspected DPLD (clinical and radiological findings), who underwent TBCB in our institution to establish a definitive diagnosis, were reviewed. In our institution, TBCB is monitored with fluoroscopy and performed under general anaesthesia by a multidisciplinary team (an anaesthesiologist, a pulmonologist and an interventional radiologist). In each patient, four samples were collected using a 2.4‐mm distal diameter cryoprobe. To control bleeding, the biopsied segmental bronchus was blocked with a 6‐mm diameter angioplasty balloon, inserted over a 0.035‐inch angled hydrophilic guidewire. After the cryoextraction, the balloon was inflated for 3 min intervals until bleeding stopped. Results Overall, 98% of samples had diagnostic value. In 85% of cases, DPLD was confirmed, while in 7%, cancer was diagnosed. Complications were observed in 16% of the patients: 13 patients developed moderate haemorrhage, and 3 developed pneumothorax. Conclusion Transbronchial cryobiopsy had a high diagnostic yield for DPLD. Performing the procedure under fluoroscopy guidance and using angioplasty balloon for selective bronchial blockade achieved a low rate of iatrogenic complications directly associated with the technique.