Radial Probe Ultrasound-Guided Cryobiopsy.
Fluoroscopy-guided transbronchial forceps biopsy has a low diagnostic yield in patients with radiographic suspicion of interstitial lung disease. Cryobiopsy has a higher diagnostic yield likely due to preserved lung architecture and larger biopsies; however, there is an increased risk of major airway bleeding and pneumothorax. Simultaneous use of endobronchial balloon blocker allows for containment of bleeding after cryobiopsy to the affected lobe. In the current article we describe use of radial ultrasound in identification of a target lung parenchyma without a major blood vessel adjacent to distal bronchi. After fluoroscopic marking of the selected airway a 3 second cryobiopsy was performed after localization of cryoprobe. Simultaneous use of radial ultrasound and fluoroscopy can possibly decrease bleeding complication associated with cryobiopsy in patients with suspected interstitial lung disease.
Departments of *Pulmonary, Critical Care and Sleep Medicine §Pathology, Creighton University, Omaha, NE †Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of New Mexico, Albuquerque, NM ‡Department of Medicine, Section of Pulmonary Diseases and Critical Care, Center for Interventional Pulmonology, University of Oklahoma, Oklahoma City, OK ∥Department of Internal Medicine, Pulmonary, Critical Care and Sleep Medicine, Faith Regional Healthcare System, Norfolk, NE.
Ilya G
IG
Berim
Ali I
AI
Saeed
Ahmed
A
Awab
Adam
A
Highley
Agnes
A
Colanta
Fawad
F
Chaudry
D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy / Q000009:adverse effects*; D003452:Cryosurgery / Q000009:adverse effects*; D005260:Female; D005471:Fluoroscopy / Q000295:instrumentation; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014463:Ultrasonography / Q000295:instrumentation