"To do or not to do - that is the question". Transvascular needle aspiration during EBUS (EBUS-TVNA) with review of the literature

Adv Respir Med. 2021;89(4):386-391. doi: 10.5603/ARM.a2021.0074.

Abstract

Introduction: Large vessels are often encountered during endobronchial ultrasound (EBUS). Safety of traversing the vessels weighed against a more invasive procedure can be a dilemma.

Material and methods: We describe a case series of 8 patients who underwent transvascular needle aspiration during EBUS, to access a lesion in the absence of an alternate safe window. A 21 gauge EBUS needle was used to traverse either the main or a major branch of the pulmonary artery.

Results: Malignancy was suspected at ROSE in five cases. Granuloma and necrosis noted in 2 cases were confirmed as tubercu-losis on culture. Diagnostic yield of EBUS-TVNA was 87.5% (7/8). No complications were noted in the immediate post-operative period as well as during 6 months of follow up.

Conclusion: EBUS-TVNA in carefully selected patients is a feasible alternative to more invasive procedures with excellent yield. Appropriate intraoperative, perioperative and postoperative monitoring and care must be available in the case of fatal bleeds.

Keywords: EBUS; TVNA; transvascular; transvascular biopsy; transvascular needle aspiration.

Publication types

  • Review

MeSH terms

  • Adult
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / methods*
  • Female
  • Granuloma, Respiratory Tract / pathology
  • Humans
  • Image-Guided Biopsy / methods*
  • Lung / pathology*
  • Lung Neoplasms / pathology*
  • Lymph Nodes / pathology*
  • Male
  • Middle Aged