Defining expanded areas in EBUS sampling: EBUS guided trans- and intra-pulmonary artery needle aspiration, with review of transvascular EBUS

Clin Respir J. 2018 May;12(5):1958-1963. doi: 10.1111/crj.12764. Epub 2018 Feb 19.

Abstract

Background: Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) has revolutionized the diagnostic approach to mediastinal diseases. Lesions located lateral to the pulmonary artery (trans-PA, Station 5), or in the lumen of the PA (intra-PA) are in the 'blind-spot' of EBUS.

Objectives: We describe a case series where EBUS guided trans-pulmonary or intra-pulmonary aspiration (EBUS-TIPNA) was used for diagnosis.

Methods: Retrospective analysis of 10 patients who had EBUS-TIPNA over 3 years in 2 centres. The inclusion criteria included patients with station 5 lesions, or intrapulmonary artery lesions, where no other option was possible.

Results: The study included 4 males and 6 females, mean age 52 years, with 7 trans-PA and 3 intra-PA lesions. Adequacy was seen in 10/10, and a definitive diagnosis was made in 9/10 patients. There were no procedure-related complications.

Conclusion: EBUS-TIPNA can be done as a safe and successful procedure and adds to the armamentarium of Convex Probe-EBUS (CP-EBUS), in carefully selected patients.

Keywords: EBUS-TBNA; intravascular; lymph nodes; pathology; retrospective study; sampling; transvascular.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / methods*
  • Female
  • Humans
  • Image-Guided Biopsy / methods
  • Lung / blood supply
  • Lung / pathology*
  • Lung Neoplasms / pathology
  • Lymph Nodes / pathology
  • Male
  • Mediastinal Diseases / diagnostic imaging
  • Mediastinal Diseases / pathology
  • Mediastinum / pathology
  • Middle Aged
  • Pulmonary Artery / pathology*
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods
  • Ultrasonography / instrumentation*
  • Ultrasonography / methods