SESSION TITLE: ILD
SESSION TYPE: Slide Presentations
PRESENTED ON: Saturday, March 22, 2014 at 12:15 PM - 01:15 PM
PURPOSE: To assess the diagnostic yield and complications associated to cryobiopsies in ILD diagnosis.
METHODS: From January 2012 to June 2013, 56 CBTB were done in 54 patients in the interventional radiology area with general anesthesia and endotracheal tube. The cryoprobe was introduced through the videobronchoscopy and targeted to a previously selected lung area under fluoroscopic guidance. The probe was cooled for 4 seg and then retracted; with the frozen lung tissue being attached to the probes tip. In 16 patients a balloon catheter was used for hemostasis by distant occlusion of the bronchus. After the intervention patients were extubated and monitorizated during 3-4h.
RESULTS: 70.4% of the patients were male and the mean age was 63.2 year (37-85). 83.6% of biopsies were made on interstitial pattern. From 3 to 6 specimens were taken from each patient: 2 in 22.9%, 3 in 29.5%, 4 in 42.6%, 5 in 3.2% and 6 in 1.6% The biopsied lobes were: 31 right lower lobe, 16 left lower lobe, 3 middle lobe, 6 lingual, 6 left upper lobe, and 4 right upper lobe. 27.8% of the biopsies were taken from different segments. 8 patients presented moderated bleed. Two patients were hospitalized during 24h due to acute respiratory failure. Neither pneumothorax nor exitus were registered. 96.7% obtained samples were suitable for analysis and in 86.8% a definitive anathomopathological diagnosis was made: Langerhans cell histiocytosis (2/61), UIP (19/61), sarcoidosis (3/61), NSIP (3/61), lymphoma (3/61), carcinomatous lymphangitis (1/61), LAM (1/61), pharmacological toxicity (3/61), bronchiolitis (1/61), organizing pneumonia (2/61), hypersensitivity pneumonitis(5/61), diffuse alveolar damage (2/61), alveolar hemorrhage (2/61), lepidic lesions (3/61), negative for malignancy (1/61).
CONCLUSIONS: The diagnostic yield of CBTB in our patients is 86.8%. This technique is safe with a low rate of complications, which are solved during the technique.
CLINICAL IMPLICATIONS: Cryobiopsy gives evidence of a reliable alternative to transbronchial biopsy with forceps in ILD.
DISCLOSURE: The following authors have nothing to disclose: Helena Azcuna, Julio Pérez Izquierdo, Myriam Aburto, Inmaculada Barredo, Jose Javier Echeverria, Luis Tena, Sandra Dorado, Amaia Garcia Loizaga, Arantza Romani, Amaia Aramburu, Ane Uranga, Cristobal Esteban, Alberto Capelastegui
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