title: Usefulness of an angioplasty balloon as selective bronchial blockade device after transbronchial cryobiopsy.
abstract: 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).
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Radiology, Hospital Galdakao Usansolo, Basque Country, Spain.
authors.forename: José Javier
authors.identifier: 0000-0003-1399-7447
authors.initials: JJ
authors.lastname: Echevarria-Uraga
authors.affiliation: Department of Pulmonology, Hospital Galdakao Usansolo, Basque Country, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Pérez-Izquierdo
authors.affiliation: Department of Radiology, Hospital Galdakao Usansolo, Basque Country, Spain.
authors.forename: Nerea
authors.initials: N
authors.lastname: García-Garai
authors.affiliation: Department of Radiology, Hospital Galdakao Usansolo, Basque Country, Spain.
authors.forename: Estíbaliz
authors.initials: E
authors.lastname: Gómez-Jiménez
authors.affiliation: Department of Pulmonology, Hospital Galdakao Usansolo, Basque Country, Spain.
authors.forename: Amaia
authors.initials: A
authors.lastname: Aramburu-Ojembarrena
authors.affiliation: Department of Anesthesiology, Hospital Galdakao Usansolo, Basque Country, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Tena-Tudanca
authors.affiliation: Department of Radiology, Hospital Galdakao Usansolo, Basque Country, Spain.
authors.forename: José L
authors.initials: JL
authors.lastname: Miguélez-Vidales
authors.affiliation: Department of Pulmonology, Hospital Galdakao Usansolo, Basque Country, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Capelastegui-Saiz
mesh_terms: D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods*; D001999:Bronchoscopy / Q000379:methods*; D015925:Cryopreservation / Q000379:methods; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects / Q000379:methods; D008168:Lung / Q000473:pathology*; D017563:Lung Diseases, Interstitial / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D012189:Retrospective Studies; D013030:Spain; D013048:Specimen Handling / Q000009:adverse effects / Q000379:methods
keywords: angioplasty balloon; bronchoscopy; cryoablation; diffuse parenchymal lung diseases; image-guided biopsy